| NPI | 1144437914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NV 12816) |
| Additional Taxonomies | 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: CA A87454) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2008-08-04 |