| NPI | 1932398203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME126549) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35-096340) |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: NM MD2014-0887) | |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: FL me126549) | |
| Enumeration Date | 2007-10-23 |
| Last Update Date | 2021-09-17 |