| NPI | 1063489367 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: PA MD043441E) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 202045) |
| Enumeration Date | 2006-03-06 |
| Last Update Date | 2014-10-30 |