| NPI | 1033329677 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME144441) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301093504) |
| 2085N0700X Radiology, Neuroradiology (Licence: FL ME144441) | |
| 2085N0700X Radiology, Neuroradiology (Licence: MI 4301093504) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME144441) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MI 4301093504) | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2021-02-15 |