| NPI | 1902268626 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME165404) |
| Additional Taxonomies | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: MT 88968) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: UT 11843884-1205) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2025037469) | |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: UT 11843884-1205) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35.149440) | |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2025-10-02 |