| NPI | 1053430157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME101063) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: FL ME101063) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2024-01-31 |