| NPI | 1013275700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: CA A153824) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A153824) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A1513824) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA A153824) | |
| Enumeration Date | 2012-05-01 |
| Last Update Date | 2021-08-06 |