| NPI | 1902919301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CO 47802) |
| Additional Taxonomies | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: CO 47802) |
| 2085N0700X Radiology, Neuroradiology (Licence: CO 47802) | |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2024-02-01 |