| NPI | 1811977267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: WA MD00047269) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: MO 2010003283) |
| 2085N0700X Radiology, Neuroradiology (Licence: IL 036.126349) | |
| 2085N0700X Radiology, Neuroradiology (Licence: IA 39705) | |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2011-11-21 |