| NPI | 1538115423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: MD D0056183) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MD D0056183) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.080358) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD416976) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 200000198) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 28302) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME94700) | |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2009-02-27 |