| NPI | 1144513177 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: TX S0502) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT199111) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2016009664) | |
| Enumeration Date | 2011-05-24 |
| Last Update Date | 2022-10-18 |