| NPI | 1255309555 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology Neuroradiology (Licence: CA C035147) |
| Additional Taxonomies | 2084N0402X Psychiatry & Neurology Neurology with Special Qualifications in Child Neurology (Licence: CA C035147) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: CA C035147) | |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2013-11-13 |