| NPI | 1972657609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology Neuroradiology (Licence: TN 49515) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: TN MD49515) |
| 2084V0102X Psychiatry & Neurology Vascular Neurology (Licence: TN 49515) | |
| 2084V0102X Psychiatry & Neurology Vascular Neurology (Licence: IA 39587) | |
| 2085N0700X Radiology Neuroradiology (Licence: CA A103026) | |
| 2085N0700X Radiology Neuroradiology (Licence: IA 39587) | |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: TN 49515) | |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2022-03-29 |