| NPI | 1972859767 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: FL ME156611) |
| Additional Taxonomies | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: MN 61825) |
| Enumeration Date | 2012-07-30 |
| Last Update Date | 2022-09-26 |