| NPI | 1952862054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: KS 04-51029) |
| Additional Taxonomies | 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: MO 2025015771) |
| 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: WI 86037-20) | |
| Enumeration Date | 2019-03-29 |
| Last Update Date | 2025-09-26 |