NPI | 1093004939 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301508236) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MD D88844) |
2084N0400X Psychiatry & Neurology, Neurology (Licence: PA TMD005113) | |
2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 278867) | |
2085R0202X Radiology, Diagnostic Radiology (Licence: PA TMD005113) | |
2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD455929) | |
2085R0202X Radiology, Diagnostic Radiology (Licence: MD D88844) | |
208D00000X General Practice (Licence: MA 278867) | |
Enumeration Date | 2011-03-31 |
Last Update Date | 2022-10-20 |