| 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 |