| NPI | 1497027387 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 38431) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: AL 38431) |
| 2085N0700X Radiology, Neuroradiology (Licence: CA a115890) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A115890) | |
| Enumeration Date | 2012-02-07 |
| Last Update Date | 2023-06-29 |