| NPI | 1922391796 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: CA A180411) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: NY 304722) |
| 2085N0700X Radiology, Neuroradiology (Licence: PA MD459016) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX Q1484) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 304722) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 1988-320) | |
| Enumeration Date | 2011-05-26 |
| Last Update Date | 2023-08-04 |