| NPI | 1568845279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: DE C1-0025038) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: PA MD477874) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD477874) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: DE C1-0025038) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.139431) | |
| Enumeration Date | 2015-06-30 |
| Last Update Date | 2023-01-31 |