| NPI | 1750508453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 52256) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A99137) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 104357) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 52256) | |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2020-10-20 |