NPI | 1679684872 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2020-02857) |
Additional Taxonomies | 174400000X Specialist (Licence: MI 4301077845) |
207T00000X Neurological Surgery (Licence: MS 22774) | |
2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MS 22774) | |
Enumeration Date | 2006-08-31 |
Last Update Date | 2024-10-18 |