| NPI | 1760737738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 71328) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R-9625) |
| 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: IA R9324) | |
| 2085N0700X Radiology, Neuroradiology (Licence: IA MD-45013) | |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2022-12-28 |