NPI | 1265658793 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: NY 249045) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 249045) |
2084N0400X Psychiatry & Neurology, Neurology (Licence: CA C151601) | |
2084N0400X Psychiatry & Neurology, Neurology (Licence: CT 56745) | |
2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: NJ 25MA08425200) | |
2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NJ 25MAO8425200) | |
Enumeration Date | 2007-04-17 |
Last Update Date | 2025-03-26 |