| NPI | 1972529220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: AK MEDS2511) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AK 2511) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2026-03-02 |