| NPI | 1942731781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: TN 55541) |
| Additional Taxonomies | 2084V0102X Psychiatry & Neurology Vascular Neurology (Licence: TN 55541) |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2017-03-23 |