| NPI | 1982860508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: WA MD60367373) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: OR MD187650) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD60367373) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD187650) | |
| Enumeration Date | 2008-08-04 |
| Last Update Date | 2018-08-01 |