| NPI | 1649311614 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology Neuroradiology (Licence: AZ 35810) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: AZ 35810) |
| Enumeration Date | 2007-02-10 |
| Last Update Date | 2020-09-08 |