| NPI | 1053547596 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: PA MD435064) |
| Additional Taxonomies | 2085N0904X (Licence: PA MD435064) |
| Enumeration Date | 2009-06-10 |
| Last Update Date | 2018-09-20 |