| NPI | 1972823599 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: TX R1685) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10038240) |
| 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: UT 8153422) | |
| 2085N0700X Radiology, Neuroradiology (Licence: UT 8153422) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: UT 8153422) | |
| Enumeration Date | 2010-06-05 |
| Last Update Date | 2022-07-21 |