| NPI | 1336100056 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: MI 4301047676) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301047676) |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2022-10-07 |