| NPI | 1477905545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: AZ 64850) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301110752) |
| Enumeration Date | 2016-07-12 |
| Last Update Date | 2022-06-09 |