| NPI | 1831288307 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2001026669) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: MO 2001026669) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101234733) | |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2014-02-07 |