| NPI | 1871582981 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: LA MD.14498R) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: NC 200300380) |
| 2085N0700X Radiology, Neuroradiology (Licence: TX K7822) | |
| 2085N0700X Radiology, Neuroradiology (Licence: OR MD26966) | |
| 2085N0700X Radiology, Neuroradiology (Licence: MS 19087) | |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2015-03-16 |