| NPI | 1295081461 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: ND PT15146) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 107077) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 56991) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: ND PT15146) | |
| Enumeration Date | 2012-07-25 |
| Last Update Date | 2018-06-15 |