| NPI | 1821095845 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: OR MD27519) |
| Additional Taxonomies | 2085N0700X Radiology Neuroradiology (Licence: LA 08567R) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: LA 08567R) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: MS 15840) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: TX L4225) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: FL 79147) | |
| 2085N0700X Radiology Neuroradiology (Licence: TX L4225) | |
| 2085N0700X Radiology Neuroradiology (Licence: OR MD27519) | |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2012-07-25 |