| NPI | 1356877476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: WA MD61413440) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 226945) |
| 2085N0700X Radiology, Neuroradiology (Licence: MT MED-PHYS-LIC-126148) | |
| Enumeration Date | 2017-05-10 |
| Last Update Date | 2023-07-15 |