| NPI | 1164664421 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: PA MD442174) |
| Additional Taxonomies | 2085N0700X Radiology Neuroradiology (Licence: VA 0101271954) |
| 2085N0700X Radiology Neuroradiology (Licence: PA MD442174) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: VA 0101271954) | |
| Enumeration Date | 2009-04-01 |
| Last Update Date | 2023-12-05 |