| NPI | 1417490301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: ND 19081) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL U05266) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: DE C2-0024603) | |
| Enumeration Date | 2016-11-23 |
| Last Update Date | 2024-10-07 |