| NPI | 1609877067 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME83053) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: NY 221093) |
| 2085N0700X Radiology, Neuroradiology (Licence: VA 0101229014) | |
| 2085N0700X Radiology, Neuroradiology (Licence: FL ME83053) | |
| 2085N0700X Radiology, Neuroradiology (Licence: CO 42151) | |
| 2085N0700X Radiology, Neuroradiology (Licence: CA AFE45310) | |
| 2085N0700X Radiology, Neuroradiology (Licence: DE C10005885) | |
| 2085N0700X Radiology, Neuroradiology (Licence: TX M7656) | |
| 2085N0700X Radiology, Neuroradiology (Licence: PA MD072116L) | |
| 2085N0700X Radiology, Neuroradiology (Licence: OH 35077791S) | |
| 2085N0700X Radiology, Neuroradiology (Licence: MD D0045541) | |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2022-07-05 |