| NPI | 1346803806 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2025-01570) |
| Additional Taxonomies | 2085N0904X (Licence: CO DR.0071888) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0071888) | |
| 2085P0229X Radiology, Pediatric Radiology (Licence: CO DR.0071888) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CO DR.0071888) | |
| Enumeration Date | 2019-04-19 |
| Last Update Date | 2025-06-18 |