| NPI | 1053391953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: DE C10004811) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0065095) |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: DE C10004811) | |
| 2085B0100X Radiology, Body Imaging (Licence: DE C10004811) | |
| 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: DE C10004811) | |
| 2085P0229X Radiology, Pediatric Radiology (Licence: DE C10004811) | |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2024-08-29 |