| NPI | 1033169438 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 50410-20) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: WA MD00036153) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 296857) | |
| 2085N0700X Radiology, Neuroradiology (Licence: WA MD00036153) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD00036153) | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2024-10-15 |