| NPI | 1407032071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME149061) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: TX N7021) |
| 2085N0700X Radiology, Neuroradiology (Licence: FL ME149061) | |
| 2085N0700X Radiology, Neuroradiology (Licence: MA 235116) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 121928) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 57615) | |
| Enumeration Date | 2008-01-14 |
| Last Update Date | 2023-08-02 |