| NPI | 1679554356 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology Neuroradiology (Licence: PA MD426250) |
| Additional Taxonomies | 2085N0700X Radiology Neuroradiology (Licence: NJ 25MA10603200) |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2019-07-08 |