| NPI | 1992788947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: FL Certification #40560) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME66429) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 200201629) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 118129) | |
| Enumeration Date | 2005-11-23 |
| Last Update Date | 2007-07-09 |