| NPI | 1487920815 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology Neuroradiology (Licence: AZ 57623) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: UT 10179216-1205) |
| Enumeration Date | 2012-03-29 |
| Last Update Date | 2024-01-10 |