| NPI | 1477978534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: CA A154586) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: MO 2016041478) |
| 2085N0700X Radiology, Neuroradiology (Licence: VA 01019542088) | |
| 2085N0700X Radiology, Neuroradiology (Licence: NC 2025-00218) | |
| Enumeration Date | 2014-02-26 |
| Last Update Date | 2025-04-16 |