| NPI | 1023245115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IA R-8862) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: IA MD42022) |
| 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: IA MD42022) | |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: IA MD42022) | |
| 2085H0002X Radiology, Hospice and Palliative Medicine (Licence: IA MD42022) | |
| 2085N0700X Radiology, Neuroradiology (Licence: IA MD42022) | |
| 2085N0904X Radiology, Nuclear Radiology (Licence: IA MD42022) | |
| 2085P0229X Radiology, Pediatric Radiology (Licence: IA MD42022) | |
| Enumeration Date | 2009-06-16 |
| Last Update Date | 2016-05-13 |