| NPI | 1730154170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: OK 24754) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: OK 24754) |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2021-07-15 |