| NPI | 1104835875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME147601) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: KY 42026) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI EMC0000655) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: OH 35.097498) | |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: CO DR.0058097) | |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: OH 35.097498) | |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: OK 37755) | |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2023-02-02 |