| NPI | 1144494584 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology Neuroradiology (Licence: IL 036-116127) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: OH 093376) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: NV 13005) | |
| Enumeration Date | 2008-04-16 |
| Last Update Date | 2009-06-10 |