NPI | 1164698460 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: UT 14237463-1205) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX U2675) |
2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TX U2675) | |
207U00000X Nuclear Medicine (Licence: GA 63755) | |
207U00000X Nuclear Medicine (Licence: TX U2675) | |
2085P0229X Radiology, Pediatric Radiology (Licence: TX U2675) | |
Enumeration Date | 2008-05-06 |
Last Update Date | 2025-09-08 |