| NPI | 1831312099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: TX M7934) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX M7934) |
| 2085N0700X Radiology, Neuroradiology (Licence: NY 241409-1) | |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2024-06-06 |