| NPI | 1528035920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NH 12979) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A71610) |
| 2085N0700X Radiology, Neuroradiology (Licence: CA A71610) | |
| Enumeration Date | 2006-03-03 |
| Last Update Date | 2023-09-08 |