| NPI | 1003841651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085B0100X Radiology Body Imaging |
| Additional Taxonomies | 2085N0700X Radiology Neuroradiology |
| 2085N0904X Radiology Nuclear Radiology | |
| 2085P0229X Radiology Pediatric Radiology | |
| 2085R0202X Radiology Diagnostic Radiology | |
| 2085U0001X Radiology Diagnostic Ultrasound | |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2007-07-09 |