| NPI | 1780857490 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: VA 0101262870) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: UT 6560247-1205) |
| Enumeration Date | 2008-04-03 |
| Last Update Date | 2017-11-03 |