| NPI | 1922292259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: TX N5870) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX N5870) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TX N5870) | |
| Enumeration Date | 2007-08-29 |
| Last Update Date | 2013-01-29 |