| NPI | 1841426400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME175404) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 58603) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MN 58603) | |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: MN 58603) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: SD 10113) | |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: SD 10113) | |
| Enumeration Date | 2009-06-09 |
| Last Update Date | 2025-12-01 |