| NPI | 1427020726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: SC 34554) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD026054E) |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2012-06-07 |