| NPI | 1740448257 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: OR 126186) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: WA 60094889) |
| Enumeration Date | 2008-05-30 |
| Last Update Date | 2015-08-18 |