| NPI | 1972534667 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2019-02683) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 49900) |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: MN 49900) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2019-11-11 |