NPI | 1366658627 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: OR MD192398) |
Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: OR MD192398) |
Enumeration Date | 2007-05-15 |
Last Update Date | 2023-04-28 |