| NPI | 1780919092 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: MN 26318) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 241986) |
| 207R00000X Internal Medicine (Licence: TX BP10038939) | |
| Enumeration Date | 2009-10-05 |
| Last Update Date | 2014-09-19 |