| NPI | 1629148010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IA MD-42012) |
| Additional Taxonomies | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: IA MD-42012) |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: IA MD-42012) | |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2023-11-17 |