| NPI | 1235202482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TX P1249) |
| Additional Taxonomies | 2085N0904X Radiology, Nuclear Radiology (Licence: MA 230399) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 230399) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX P1249) | |
| 207U00000X Nuclear Medicine (Licence: MA 230399) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MA 2303099) | |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2021-01-07 |