NPI | 1457611873 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME144223) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL 144223) |
207T00000X Neurological Surgery (Licence: FL 17373) | |
Enumeration Date | 2012-05-18 |
Last Update Date | 2021-07-02 |