| NPI | 1437279288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X (Licence: CT 049984) |
| Additional Taxonomies | 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: CT 049984) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 049984) | |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2014-02-28 |