| NPI | 1720047491 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology Neuroradiology (Licence: MA 155303) |
| Additional Taxonomies | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: MA 155303) |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2010-10-05 |