| NPI | 1174770382 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: TX R7675) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TX R7675) |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: OR MD153862) | |
| 2084N0400X Psychiatry & Neurology Neurology (Licence: CA A105812) | |
| 2084V0102X Psychiatry & Neurology Vascular Neurology (Licence: OR MD153862) | |
| 2084V0102X Psychiatry & Neurology Vascular Neurology (Licence: TX R7675) | |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: TX R7675) | |
| Enumeration Date | 2008-08-20 |
| Last Update Date | 2022-04-20 |