| NPI | 1396908026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: SC 30993) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: NC 2012-01849) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 30993) | |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2022-12-13 |