| NPI | 1962477752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: WV 25064) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: CO DR.0067382) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: WV 25064) | |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2021-11-22 |