| NPI | 1902037880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: PR 17,921) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: TX N3248) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX N3248) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PR 17,921) | |
| Enumeration Date | 2009-07-27 |
| Last Update Date | 2018-08-20 |