| NPI | 1306835368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: NE 26397) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 25156) |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2016-11-23 |