| NPI | 1720766025 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0904X Radiology, Nuclear Radiology (Licence: AZ R80219) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: AZ R80219) |
| Enumeration Date | 2023-07-06 |
| Last Update Date | 2024-05-03 |