| NPI | 1679773881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: PA MD425912) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: FL ME125610) |
| Enumeration Date | 2007-07-25 |
| Last Update Date | 2023-10-24 |