| NPI | 1952663270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: TX T7542) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: MO 2017008631) |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2022-10-19 |