| NPI | 1043284987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: PA MD426682) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD426682) |
| 2085D0003X Radiology Diagnostic Neuroimaging (Licence: OH 35.089287) | |
| Enumeration Date | 2006-02-16 |
| Last Update Date | 2008-01-22 |