| NPI | 1346508033 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: WI 61575) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 61575-20) |
| Enumeration Date | 2012-05-01 |
| Last Update Date | 2018-07-26 |