NPI | 1063438299 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101280416) |
Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: VA 0101280416) |
2085N0700X Radiology, Neuroradiology (Licence: IA MD43047) | |
2085N0700X Radiology, Neuroradiology (Licence: MO 105361) | |
Enumeration Date | 2006-07-14 |
Last Update Date | 2024-01-05 |