| NPI | 1366490617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: FL ME85283) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: ID M-10835) |
| 2085N0700X Radiology, Neuroradiology (Licence: LA MD201699) | |
| 2085N0700X Radiology, Neuroradiology (Licence: TN 44627) | |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2018-04-30 |