| NPI | 1427068766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME120298) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: FL ME120298) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MS 21778) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NH 13484) | |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2021-09-07 |