| NPI | 1295900249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2010-02014) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: SC 34784) |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2013-12-31 |