| NPI | 1447699970 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: SC 35953) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2015-01042) |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: NC LL35953) | |
| Enumeration Date | 2013-06-18 |
| Last Update Date | 2019-06-05 |