| NPI | 1225069800 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: FL ME152526) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: TX N5422) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX N5422) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2024-02-20 |