| NPI | 1922418797 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: CA A142728) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A142728) |
| 2085N0700X Radiology, Neuroradiology (Licence: CA A142728) | |
| Enumeration Date | 2014-05-02 |
| Last Update Date | 2024-04-08 |