| NPI | 1518565910 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: CO TL.0010471) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4352001057) |
| Enumeration Date | 2020-10-16 |
| Last Update Date | 2024-05-02 |