| NPI | 1013276021 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2012-02013) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: NC 2012-02013) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101270926) | |
| Enumeration Date | 2012-05-10 |
| Last Update Date | 2023-04-27 |