| NPI | 1487048864 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME141161) |
| Additional Taxonomies | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: FL ME141161) |
| 2085N0700X Radiology, Neuroradiology (Licence: FL ME141161) | |
| Enumeration Date | 2015-03-24 |
| Last Update Date | 2024-04-29 |