| NPI | 1750744264 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: FL ME150904) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: NC 2021-00152) |
| Enumeration Date | 2016-04-01 |
| Last Update Date | 2023-03-27 |