| NPI | 1891701777 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: CT 045353) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: MA 223515) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2018-03-17 |