| NPI | 1295154524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 65980-20) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: WI 65980) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 5471-851) | |
| 2085N0700X Radiology, Neuroradiology (Licence: WA 60943180) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WA 60943180) | |
| 207R00000X Internal Medicine (Licence: IL 125065160) | |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2020-07-08 |