| NPI | 1891960860 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: OR MD10835) |
| Additional Taxonomies | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: OR md10835) |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2016-02-29 |