| NPI | 1346637824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X (Licence: VA 0102209821) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA 20A18181) |
| 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: CA 20A18181) | |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2026-05-21 |