| NPI | 1598086365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: TX P1490) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 261935) |
| Enumeration Date | 2010-06-16 |
| Last Update Date | 2023-02-02 |