| NPI | 1871815225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: WI 53632) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 05167) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: ND 12132) | |
| Enumeration Date | 2010-02-25 |
| Last Update Date | 2020-09-11 |