| NPI | 1629068333 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: DC MD20011) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0045161) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D45161) | |
| 2085N0700X Radiology, Neuroradiology (Licence: MD D0045161) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: DC MD20011) | |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2020-10-01 |