| NPI | 1568670149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301086442) |
| Additional Taxonomies | 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: NC 163466) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2013-08-30 |