| NPI | 1811224561 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD448952) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: MA 242154) |
| Enumeration Date | 2009-11-17 |
| Last Update Date | 2013-11-08 |