NPI | 1093183543 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NY 310669) |
Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WI 1-876) |
2085R0204X Radiology, Vascular & Interventional Radiology (Licence: WI 1-876) | |
2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NY 310669) | |
Enumeration Date | 2015-09-14 |
Last Update Date | 2021-08-06 |