| NPI | 1003894569 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: OK 25298) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: CA A85243) |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2021-06-15 |