| NPI | 1619997301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: PA MD032261E) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: NH 8974) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2018-09-06 |