| NPI | 1851683650 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: NY 329100) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: CT 61355) |
| 2085N0700X Radiology, Neuroradiology (Licence: CA A141742) | |
| Enumeration Date | 2011-05-11 |
| Last Update Date | 2024-10-29 |