| NPI | 1396929766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology Neuroradiology (Licence: NY 236700) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: IN 01064653A) |
| 2085N0700X Radiology Neuroradiology (Licence: IN 01064653A) | |
| Enumeration Date | 2007-12-20 |
| Last Update Date | 2011-10-03 |