| NPI | 1356589980 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME164442) |
| Additional Taxonomies | 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: MA 238500) |
| 2085N0700X Radiology, Neuroradiology (Licence: MA 238500) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 238500) | |
| Enumeration Date | 2009-02-04 |
| Last Update Date | 2023-12-21 |