| NPI | 1083698385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology Neuroradiology (Licence: CO 44660) |
| Additional Taxonomies | 2085N0700X Radiology Neuroradiology (Licence: NC 200400806) |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2016-03-08 |