| NPI | 1306343157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085N0700X Radiology Neuroradiology (Licence: MA 295370) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: MA 295370) |
| Enumeration Date | 2018-04-09 |
| Last Update Date | 2024-11-08 |