| NPI | 1720101199 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology Neuroradiology (Licence: AL L.4309SP) |
| Additional Taxonomies | 2085D0003X Radiology Diagnostic Neuroimaging (Licence: MO 2007006976) |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2016-07-09 |