| NPI | 1013442565 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: OK 43281) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 13475) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2025-01444) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 202501444) | |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: WI 13475) | |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: OK 43281) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: WI 13475) | |
| Enumeration Date | 2017-04-21 |
| Last Update Date | 2025-08-04 |