| NPI | 1356326003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: VA 0101253004) |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: IN 01050455A) |
| 2085N0700X Radiology, Neuroradiology (Licence: MA 242457) | |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2013-02-18 |