| NPI | 1881654648 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 052598) |
| Additional Taxonomies | 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: GA 052598) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2010-07-30 |