| NPI | 1780845412 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: VA 0101256143) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: DC MD039783) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2020-12-07 |