| NPI | 1205862869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: VA 0101240118) |
| Additional Taxonomies | 2084V0102X Psychiatry & Neurology Vascular Neurology (Licence: VA 0101240118) |
| 2085D0003X Radiology Diagnostic Neuroimaging (Licence: VA 0101240118) | |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2024-04-10 |