| NPI | 1003300096 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NJ 25MA11629800) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA11629800) |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: NY 318778) | |
| 207T00000X Neurological Surgery (Licence: NJ 25MA11629800) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NY 318778) | |
| 207T00000X Neurological Surgery (Licence: NY 318778) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NJ 25MA11629800) | |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: NJ 25MA11629800) | |
| Enumeration Date | 2018-06-21 |
| Last Update Date | 2026-01-26 |