| NPI | 1114968328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: TN 59813) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: CA A20476) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2019-12-02 |