| NPI | 1427108737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: NY 264447) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL TRN10188) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A104500) | |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2013-07-15 |