| NPI | 1831124031 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: FL ME145792) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: MN 44222) |
| 2085N0700X Radiology, Neuroradiology (Licence: FL 145792) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 44222) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL 145792) | |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2020-06-10 |