| NPI | 1366493678 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: MI 4301504400) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: WA 61382258) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301504400) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OR 24839) | |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2023-11-03 |