| NPI | 1114958741 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 047380) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: GA 47380) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2016-11-10 |