| NPI | 1255537122 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology Neurocritical Care (Licence: GA 059523) |
| Additional Taxonomies | 2084V0102X Psychiatry & Neurology Vascular Neurology (Licence: GA 059523) |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: GA 059523) | |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2017-04-19 |