| NPI | 1215101167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA 110406) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0054593) |
| 2085P0229X Radiology, Pediatric Radiology (Licence: CA 110406) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 72418) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01095426A) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: ME MD29036) | |
| 2085P0229X Radiology, Pediatric Radiology (Licence: CO DR.0054593) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NH 34221) | |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2026-05-18 |