| NPI | 1033119458 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NY 222575) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 222575) |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2020-12-10 |