| NPI | 1669532008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: NM MD2013-0668) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME160184) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.134086) | |
| 2085N0700X Radiology, Neuroradiology (Licence: CA A83492) | |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2023-01-12 |