| NPI | 1275675092 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 25118) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OK 25118) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 106920) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 57118) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX T4686) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 67541) | |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2022-12-08 |