| NPI | 1992392179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: OR MF214492) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: TX BP10070245) |
| Enumeration Date | 2020-12-22 |
| Last Update Date | 2023-06-05 |