| NPI | 1871812495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology Neuroradiology (Licence: CA A120475) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: CA A120475) |
| 2084V0102X Psychiatry & Neurology Vascular Neurology (Licence: CA A120475) | |
| Enumeration Date | 2010-05-21 |
| Last Update Date | 2021-04-20 |