| NPI | 1710214259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 276970) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: NY 276970) | |
| 2085N0700X Radiology, Neuroradiology (Licence: NY 276970) | |
| Enumeration Date | 2009-11-04 |
| Last Update Date | 2014-10-09 |