| NPI | 1568617108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: CA A151144) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A125809) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2012012483) | |
| 208600000X Surgery (Licence: CA A151144) | |
| Enumeration Date | 2008-11-24 |
| Last Update Date | 2020-10-02 |