| NPI | 1326129453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301077390) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: MI 4301077390) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GU M-2189) | |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2019-12-09 |