| NPI | 1760428312 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 36409) |
| Additional Taxonomies | 2085U0001X Radiology, Diagnostic Ultrasound (Licence: AZ 36409) |
| 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: AZ 36409) | |
| 2085N0700X Radiology, Neuroradiology (Licence: AZ 36409) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME147128) | |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2024-02-19 |