| NPI | 1114376332 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: CA A163187) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: PA MD454615) |
| Enumeration Date | 2016-06-08 |
| Last Update Date | 2022-11-21 |