| NPI | 1134474711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: TN 57254) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: MS 25955) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 57254) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MS 25955) | |
| Enumeration Date | 2012-07-19 |
| Last Update Date | 2019-04-03 |