| NPI | 1376937722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology Neuroradiology (Licence: NY 312082) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: AR E-14052) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: CA A171684) | |
| Enumeration Date | 2015-03-24 |
| Last Update Date | 2023-11-27 |