| NPI | 1780415067 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: ZZ 89227) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: MA 1021024) |
| Enumeration Date | 2024-08-09 |
| Last Update Date | 2024-11-01 |