| NPI | 1134193030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NH 10939) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: MA 156999) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 156999) | |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2011-07-27 |