| NPI | 1639105299 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: PA MD043428L) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: PA md043428l) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA md043428l) | |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2015-08-19 |