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 |