| NPI | 1871172486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: KS 04-51346) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2026016675) |
| Enumeration Date | 2021-04-02 |
| Last Update Date | 2026-06-22 |