| NPI | 1891851325 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: CA A116834) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT188038) |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2023-11-27 |