| NPI | 1265452395 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 29782) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 200400073) |
| 2085N0700X Radiology, Neuroradiology (Licence: NC 200400073) | |
| 2085N0700X Radiology, Neuroradiology (Licence: TN 29782) | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2007-07-08 |