| NPI | 1942531629 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA F5525) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA F5525) |
| Enumeration Date | 2010-01-20 |
| Last Update Date | 2010-01-20 |