| NPI | 1952496424 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: CT 053871) |
| Additional Taxonomies | 2085N0700X Radiology Neuroradiology (Licence: CT 05371) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2023-09-07 |