| NPI | 1043303548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME160669) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: GA 052837) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 54994) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 24871) | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2023-03-29 |