| NPI | 1114108255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD435475) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 27298) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 253022) | |
| 2085N0700X Radiology, Neuroradiology (Licence: PA MD435475) | |
| 2085N0700X Radiology, Neuroradiology (Licence: AL 27298) | |
| 2085N0700X Radiology, Neuroradiology (Licence: NY 253022) | |
| Enumeration Date | 2007-11-16 |
| Last Update Date | 2011-03-22 |