| NPI | 1447440540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: FL ME102543) |
| Additional Taxonomies | 2085N0700X Radiology Neuroradiology (Licence: FL ME102543) |
| Enumeration Date | 2007-07-26 |
| Last Update Date | 2020-09-01 |