| NPI | 1245282664 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME116151) |
| Additional Taxonomies | 174400000X Specialist (Licence: WA MD00034132) |
| 2085N0700X Radiology, Neuroradiology (Licence: FL ME116151) | |
| 174400000X Specialist (Licence: FL ME116151) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2015-03-09 |