| NPI | 1639102692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: MN 23688) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: CA G27488) |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2008-05-16 |