| NPI | 1093748873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: MO 2017030556) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: NY 261623) |
| 2085N0700X Radiology, Neuroradiology (Licence: MI 4301090934) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 261623) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301090934) | |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2022-10-05 |