| NPI | 1609118009 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology Vascular Neurology (Licence: OR MD182406) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: OR MD182406) |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: OR MD182406) | |
| Enumeration Date | 2013-03-23 |
| Last Update Date | 2022-07-14 |