| NPI | 1255312286 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO CDRH.0057736) |
| Additional Taxonomies | 207U00000X Nuclear Medicine (Licence: TX TM00851) |
| 2085N0904X (Licence: MN 74405) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WY 13032C) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX TM00851) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 19821) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME132648) | |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2025-06-09 |