| NPI | 1487610937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X (Licence: AZ 35513) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME110568) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 35513) | |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: FL ME110568) | |
| 2085N0700X (Licence: CA C54330) | |
| 2085N0700X (Licence: CO DR.0064428) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME110568) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 35513) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0064428) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: AZ 35513) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME110568) | |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2024-02-21 |