| NPI | 1992090674 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 65602-20) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: WI 65602) |
| Enumeration Date | 2011-06-10 |
| Last Update Date | 2018-09-12 |