| NPI | 1184683393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: IA 26671) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: SD 4858) |
| 2085N0700X Radiology, Neuroradiology (Licence: NE 23186) | |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2016-11-16 |