| NPI | 1689014540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X (Licence: CO DR.0070644) |
| Additional Taxonomies | 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: CA A172727) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 125067158) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A172727) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0070644) | |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2023-08-16 |