| NPI | 1407821960 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: AZ 3484) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 3484) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 32827) | |
| Enumeration Date | 2006-02-20 |
| Last Update Date | 2010-09-29 |