| NPI | 1316166630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: CA A114704) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 231639) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 47712) | |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2015-07-15 |