| NPI | 1043277205 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX R5103) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: MO 2004022978) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2004022978) | |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2024-06-11 |