| NPI | 1821203571 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: PA MD476887) |
| Additional Taxonomies | 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: DC MD041397) |
| 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: MD 0101254378) | |
| 2085N0700X Radiology, Neuroradiology (Licence: TN 47352) | |
| 2085N0700X Radiology, Neuroradiology (Licence: CA A108302) | |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2023-04-27 |