NPI | 1578805230 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME155034) |
Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: FL ME155034) |
2085N0700X Radiology, Neuroradiology (Licence: CA A133922) | |
Enumeration Date | 2013-03-20 |
Last Update Date | 2022-03-22 |