| NPI | 1942274774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME43844) |
| Additional Taxonomies | 2085N0700X (Licence: FL ME43844) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: FL ME43844) | |
| Enumeration Date | 2006-02-16 |
| Last Update Date | 2010-01-14 |