NPI | 1114178563 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IA 39120) |
Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: IA MD39120) |
2085B0100X Radiology, Body Imaging (Licence: IA 39120) | |
2085R0202X Radiology, Diagnostic Radiology (Licence: TX P4192) | |
2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IA MD39120) | |
2085U0001X Radiology, Diagnostic Ultrasound (Licence: IA MD39120) | |
Enumeration Date | 2008-10-03 |
Last Update Date | 2018-03-20 |