| NPI | 1295740082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD042881L) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: PA MD042881L) |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2012-11-01 |