NPI | 1760707236 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: VT 042.0013440) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2015-00157) |
2085R0202X Radiology, Diagnostic Radiology (Licence: SC 38000) | |
2085R0202X Radiology, Diagnostic Radiology (Licence: GA 72630) | |
2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME154739) | |
Enumeration Date | 2010-03-28 |
Last Update Date | 2022-05-18 |