| NPI | 1659578896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology Neuroradiology (Licence: TX R0605) |
| Additional Taxonomies | 2085N0700X Radiology Neuroradiology (Licence: NY 298334) |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2024-02-21 |