| NPI | 1912392887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: CA A166971) |
| Additional Taxonomies | 2085N0904X Radiology, Nuclear Radiology (Licence: CA A166971) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ R75875) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A166971) | |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2024-04-09 |