| NPI | 1023317328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: UT 8172696-1205) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: UT 8172696-1205) |
| Enumeration Date | 2011-03-25 |
| Last Update Date | 2021-12-20 |