| NPI | 1073956264 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NY 293068) |
| Additional Taxonomies | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: NY 293068) |
| 2085N0700X Radiology, Neuroradiology (Licence: NY 293068) | |
| Enumeration Date | 2013-04-08 |
| Last Update Date | 2022-11-29 |