| NPI | 1306822358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 23053) |
| Additional Taxonomies | 2085R0001X (Licence: SC 23053) |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: SC 23053) | |
| 2085R0203X Radiology, Therapeutic Radiology (Licence: SC 23053) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: SC 23053) | |
| 2085R0205X Radiology, Radiological Physics (Licence: SC 23053) | |
| 207U00000X Nuclear Medicine (Licence: SC 23053) | |
| 2085P0229X Radiology, Pediatric Radiology (Licence: SC 23053) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2008-01167) | |
| 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: SC 23053) | |
| 2085B0100X Radiology, Body Imaging (Licence: SC 23053) | |
| 2085N0700X (Licence: SC 23053) | |
| 2085N0904X (Licence: SC 23053) | |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2026-02-12 |