| NPI | 1639505142 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: MD 97-196) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: KY 59332) |
| Enumeration Date | 2013-09-17 |
| Last Update Date | 2024-07-23 |