| NPI | 1134245210 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: FL ME148543) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: VT 042.0011875) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME148543) | |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2022-07-05 |