| NPI | 1134174170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: CA A72232) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A72232) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A72232) | |
| 2085N0904X Radiology, Nuclear Radiology (Licence: CA A72232) | |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2015-07-29 |