| NPI | 1013140136 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: FL ME112657) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 272403) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME112657) | |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: NY 272403) | |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: FL ME112657) | |
| 2085N0700X Radiology, Neuroradiology (Licence: NY 272403) | |
| Enumeration Date | 2009-08-24 |
| Last Update Date | 2021-03-08 |