| 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 |