| NPI | 1821229691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: PA MD4411230) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: MI 4301093730) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301093730) | |
| Enumeration Date | 2009-07-28 |
| Last Update Date | 2011-11-28 |