| NPI | 1538504303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: WI 73413) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101274464) |
| Enumeration Date | 2013-05-06 |
| Last Update Date | 2022-11-01 |