| NPI | 1023266103 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: MA 254047) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: NC 2008-01461) |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2020-10-23 |