| NPI | 1700842556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: CA G68394) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: MA 60716) |
| 2085N0700X Radiology, Neuroradiology (Licence: NY 230729) | |
| 2085N0904X Radiology, Nuclear Radiology (Licence: FL ME61372) | |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2007-09-12 |