| NPI | 1134361215 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: MI 4301095130) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: MA 262554) |
| Enumeration Date | 2009-04-03 |
| Last Update Date | 2018-05-09 |