| NPI | 1952516825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2007012296) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: MO 2007012296) |
| Enumeration Date | 2007-05-13 |
| Last Update Date | 2024-04-25 |