| NPI | 1164577540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2007007109) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2004015892) |
| 2085B0100X Radiology, Body Imaging (Licence: MO 2007007109) | |
| 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: MO 2007007109) | |
| 2085N0700X (Licence: MO 20070071090) | |
| 2085N0700X (Licence: MO 2007007109) | |
| 2085P0229X Radiology, Pediatric Radiology (Licence: MO 2007007109) | |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: MO 2008020890) | |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2018-04-23 |