| NPI | 1932291572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2007-01242) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: UT 5211171-1205) |
| 2085N0700X Radiology, Neuroradiology (Licence: UT 5211171-1205) | |
| 2085N0700X Radiology, Neuroradiology (Licence: NC 2007-01242) | |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2014-02-13 |