| NPI | 1568430171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: CO DR.0065690) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: IA 34821) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0065690) | |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2021-01-28 |