| NPI | 1386264406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A183176) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A183176) |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: CA A183176) | |
| 2085N0700X (Licence: CA A183176) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA A183176) | |
| Enumeration Date | 2020-04-18 |
| Last Update Date | 2025-07-02 |