| NPI | 1689988644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0059831) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: CO DR.0059831) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME116629) | |
| Enumeration Date | 2010-08-02 |
| Last Update Date | 2018-07-27 |