| NPI | 1942453618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: CA 970270) |
| Additional Taxonomies | 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: CA A104971) |
| 2085N0700X Radiology, Neuroradiology (Licence: CA A104971) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A104971) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA A104971) | |
| Enumeration Date | 2008-10-28 |
| Last Update Date | 2020-12-03 |