| NPI | 1073698866 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: GA 058437) |
| Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: GA 058437) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2017-02-09 |