| NPI | 1598971913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: TX N1081) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2005-00588) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2008-11-03 |