| NPI | 1669823738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 82357) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: CO TL.0008516) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301110699) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 74577) | |
| Enumeration Date | 2016-06-29 |
| Last Update Date | 2023-08-31 |