| NPI | 1164451753 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A68837) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: DC MD036942) |
| 2085N0700X Radiology, Neuroradiology (Licence: VA 0101257982) | |
| 2085N0700X Radiology, Neuroradiology (Licence: MA 265600) | |
| 2085N0700X Radiology, Neuroradiology (Licence: MD D0077237) | |
| 2085N0700X Radiology, Neuroradiology (Licence: TX P1560) | |
| 2085N0700X Radiology, Neuroradiology (Licence: CT 054764) | |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2020-08-12 |