| NPI | 1265610638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 43472) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME 98780) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 252745-1) | |
| 2085N0700X Radiology, Neuroradiology (Licence: AZ 43472) | |
| 2085N0700X Radiology, Neuroradiology (Licence: NY 252745-1) | |
| 2085N0700X Radiology, Neuroradiology (Licence: FL ME 98780) | |
| Enumeration Date | 2008-02-07 |
| Last Update Date | 2012-11-02 |