| NPI | 1912340654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: MA 1020268) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 1020268) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 289217) | |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: NY 289217) | |
| Enumeration Date | 2013-04-11 |
| Last Update Date | 2024-10-24 |