| NPI | 1467436394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: PA MD487489) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: MD D0083946) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: MA 74590) | |
| 2085N0700X Radiology Neuroradiology (Licence: MD D0083946) | |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2025-01-15 |