| NPI | 1780669242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology Neuroradiology (Licence: NC 200200735) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: NC 200200735) |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2024-09-20 |