| NPI | 1528296415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: PA MD457776) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MT194459) |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2016-06-01 |