| NPI | 1629030291 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: TX P2650) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WI 1349) |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2012-10-19 |