| NPI | 1285763169 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: CT 049804) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: MA 221299) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2018-01-12 |