| NPI | 1225011265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME44997) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 200201218) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 026698) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 118205) | |
| 2085N0700X Radiology, Neuroradiology (Licence: FL Added Qualifications) | |
| Enumeration Date | 2005-11-23 |
| Last Update Date | 2024-02-28 |