| NPI | 1548396997 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: FL ME95124) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME95124) |
| 2085N0700X Radiology, Neuroradiology (Licence: FL ME95124) | |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2025-01-20 |