| NPI | 1962666545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: CT 061354) |
| Additional Taxonomies | 2084N0600X (Licence: NY 60-275372) |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: NY 60-275372) | |
| Enumeration Date | 2008-07-14 |
| Last Update Date | 2022-09-30 |