| NPI | 1972588556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME92353) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: DC MD31831) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 43040) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101236511) | |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2024-02-21 |