| NPI | 1346514189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OR 176837) |
| Additional Taxonomies | 2085N0700X (Licence: OR MD176837) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD176837) | |
| 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: OR MD176837) | |
| Enumeration Date | 2012-02-24 |
| Last Update Date | 2018-01-12 |