| NPI | 1407055114 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: FL ME138226) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: MO 2013040411) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX Q1044) | |
| 207R00000X Internal Medicine (Licence: ME EC071074) | |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2024-01-30 |