| NPI | 1740470855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD60507050) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A100708) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD190076) | |
| 2085N0700X Radiology, Neuroradiology (Licence: WA MD60507050) | |
| 2085N0700X Radiology, Neuroradiology (Licence: CA A100708) | |
| 2085N0700X Radiology, Neuroradiology (Licence: OR MD190076) | |
| Enumeration Date | 2007-07-26 |
| Last Update Date | 2024-04-25 |