| NPI | 1336467059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME0133033) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL TRN14640) |
| 2085N0700X Radiology, Neuroradiology (Licence: FL TRN23260) | |
| 2085N0700X Radiology, Neuroradiology (Licence: FL ME133033) | |
| Enumeration Date | 2010-05-05 |
| Last Update Date | 2024-04-03 |