| NPI | 1851603005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME164565) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: NC 2020-03898) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2020-03898) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD464041) | |
| Enumeration Date | 2010-07-03 |
| Last Update Date | 2023-09-06 |