| NPI | 1598746232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD00034694) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD162209) |
| 2085N0700X Radiology, Neuroradiology (Licence: WA MD00034694) | |
| 2085N0700X Radiology, Neuroradiology (Licence: OR MD162209) | |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2018-12-20 |