| NPI | 1124002191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: ID M10230) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: NC 94-00414) |
| 2085N0700X Radiology, Neuroradiology (Licence: SC 19589) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 9400414) | |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2022-06-28 |