| NPI | 1548422918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology Neuroradiology (Licence: TN 57652) |
| Additional Taxonomies | 2085N0700X Radiology Neuroradiology (Licence: AL 31216) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: TN 57652) | |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2019-08-20 |