| NPI | 1801003686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA A107120) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A107120) |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: CA A107120) | |
| 2085N0700X Radiology, Neuroradiology (Licence: CA A107120) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA A107120) | |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2021-11-03 |