| NPI | 1528060258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: SC 0703) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: ME 1031) |
| 2085N0700X Radiology, Neuroradiology (Licence: FL OS 8412) | |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2017-05-05 |