| NPI | 1962791467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: MA 266093) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 57898) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 266093) | |
| 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: MA 266093) | |
| Enumeration Date | 2011-04-05 |
| Last Update Date | 2018-06-26 |