| NPI | 1013063908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: FL Os9113) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2003028232) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2018-04-19 |