| NPI | 1336239946 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology Neuroradiology (Licence: CO DR.0053442) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: UT 5995797-1205) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: CO 53442) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2017-10-06 |