| NPI | 1235188434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: FL Me 103335) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 226101) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME 103335) | |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2013-05-09 |