| NPI | 1194797597 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology Neuroradiology (Licence: SC 26681) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: SC 26681) |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2023-05-18 |