| NPI | 1972685949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: CA 20A3872) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA 20A3872) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2007-10-09 |