| NPI | 1336439660 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: FL ME132724) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME132724) |
| 2085N0700X Radiology, Neuroradiology (Licence: IL 036139773) | |
| Enumeration Date | 2011-04-07 |
| Last Update Date | 2023-01-30 |