| NPI | 1295844314 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA G46445) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA G46445) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2016-07-27 |