| NPI | 1255420030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology Neuroradiology (Licence: ND 13101) |
| Additional Taxonomies | 2085N0700X Radiology Neuroradiology (Licence: NY 210975-1) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2014-11-20 |