| NPI | 1083874416 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2015000798) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: PA MD449782) |
| 2085N0700X Radiology, Neuroradiology (Licence: NC 2015-00798) | |
| Enumeration Date | 2008-06-10 |
| Last Update Date | 2020-09-12 |