| NPI | 1962666941 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME114677) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: DE C1-0009303) |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: FL ME114677) | |
| Enumeration Date | 2008-07-18 |
| Last Update Date | 2018-07-06 |