| NPI | 1619137106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: FL ME121999) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 921189) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME121999) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01089698A) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI EMC0005267) | |
| Enumeration Date | 2008-06-10 |
| Last Update Date | 2024-07-25 |