| NPI | 1508217969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology Neuroradiology (Licence: MI 4301511496) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: IN 01093080A) |
| Enumeration Date | 2016-06-28 |
| Last Update Date | 2024-07-09 |