| NPI | 1245280312 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 23288) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: OK 23288) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2011-09-09 |