| NPI | 1568548642 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 47788) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A109946) |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: CA A109946) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA A109946) | |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2021-11-24 |