| NPI | 1699959114 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology Neuroradiology (Licence: TX N9703) |
| Additional Taxonomies | 2084A2900X Psychiatry & Neurology Neurocritical Care (Licence: TX N9703) |
| Enumeration Date | 2007-12-19 |
| Last Update Date | 2020-10-16 |