| NPI | 1740337542 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL MD26715) |
| Additional Taxonomies | 174400000X Specialist (Licence: AL MD26715) |
| 2085N0700X Radiology, Neuroradiology (Licence: AL MD26715) | |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2020-11-17 |