| NPI | 1831169796 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: PA MD064664L) |
| Additional Taxonomies | 2085N0700X Radiology Neuroradiology (Licence: PA MD064664L) |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2022-03-16 |