| NPI | 1225026933 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: CT 28023) |
| Additional Taxonomies | 174400000X Specialist (Licence: CT 028023) |
| Enumeration Date | 2005-10-07 |
| Last Update Date | 2018-05-16 |