| NPI | 1144364605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: WA MD60083485) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 17687) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD60083485) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AK S-7900) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: ID M-12378) | |
| Enumeration Date | 2007-02-17 |
| Last Update Date | 2019-11-05 |