| NPI | 1972614899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CA A75862) |
| Additional Taxonomies | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: CA A75862) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A75862) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2012-09-05 |