| NPI | 1093769390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: NC 2020-04056) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OR 09360) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2020-04056) | |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2021-05-04 |