| NPI | 1396021648 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 251258) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: CT 68651) |
| 2085N0700X Radiology, Neuroradiology (Licence: CA A124590) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 257014) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 68651) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A124590) | |
| Enumeration Date | 2011-11-01 |
| Last Update Date | 2023-10-30 |