| NPI | 1609866326 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology Neuroradiology |
| Additional Taxonomies | 2085N0700X Radiology Neuroradiology (Licence: MA 219512) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: MA 219512) | |
| 2085D0003X Radiology Diagnostic Neuroimaging | |
| 2085R0202X Radiology Diagnostic Radiology | |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2007-12-12 |