| NPI | 1588734289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: SC 36833) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 36833) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A120665) | |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2021-03-12 |