| NPI | 1750700522 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: TX 47797) |
| Additional Taxonomies | 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: OH 35.139839) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX 47797) | |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: TX 47797) | |
| 2085N0700X Radiology, Neuroradiology (Licence: TX 47797) | |
| Enumeration Date | 2014-04-09 |
| Last Update Date | 2022-09-10 |