| NPI | 1982633251 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: FL ME126640) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME126640) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 2006012222) | |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2023-06-14 |