| NPI | 1407053655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: CT 48892) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: NY 234067) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 234067) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 234067) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CT 48892) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CT 48892) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 48892) | |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2011-09-15 |