| NPI | 1942463765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: OH 35136020) |
| Additional Taxonomies | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: MI 4301090828) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301090828) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35136020) | |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2021-01-29 |