| NPI | 1104142512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2020-02657) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: NC 2020-02657) |
| Enumeration Date | 2010-04-09 |
| Last Update Date | 2023-02-03 |