| NPI | 1427177120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD00048181) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: MI 4301078055) |
| 2085N0700X Radiology, Neuroradiology (Licence: WA MD00048181) | |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2024-09-03 |