| NPI | 1801091434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology Neuroradiology (Licence: PA MD473947) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: PA MD473947) |
| 2085N0700X Radiology Neuroradiology (Licence: NY 226353) | |
| 2085N0700X Radiology Neuroradiology (Licence: GA 060465) | |
| 2085N0700X Radiology Neuroradiology (Licence: TN 49169) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: PA MD473947) | |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2021-12-14 |