| NPI | 1245295682 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: FL ME0060972) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: OH 35089865) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2023-03-07 |