| NPI | 1104873587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: MO 2002031632) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MO 2002031632) |
| 207T00000X Neurological Surgery (Licence: AR E4419) | |
| 2085N0700X Radiology, Neuroradiology (Licence: AR E4419) | |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2015-08-21 |