| NPI | 1780676023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: CT 37744) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 037744) |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2022-05-25 |