| NPI | 1548512809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A127670) |
| Additional Taxonomies | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: CA A127670) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A127670) | |
| Enumeration Date | 2012-10-11 |
| Last Update Date | 2022-05-06 |