| NPI | 1326038167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: HI 10796) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: NY 318130) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 318130) | |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2022-08-31 |