| NPI | 1881793537 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology Neuroradiology (Licence: PA MD071402L) |
| Additional Taxonomies | 2085N0700X Radiology Neuroradiology (Licence: NY 262724) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2021-03-04 |