| NPI | 1346560844 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology Neuroradiology (Licence: PA OS17568) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: PA OT013585) |
| Enumeration Date | 2010-06-07 |
| Last Update Date | 2016-03-08 |