| NPI | 1891844122 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: VA 0101039893) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: NY 251415) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2023-09-12 |