| NPI | 1992994487 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA 1041870) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 264006) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: HI MD-23867) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 54494) | |
| 2085N0700X Radiology, Neuroradiology (Licence: FL ME 100215) | |
| Enumeration Date | 2007-10-19 |
| Last Update Date | 2024-03-07 |