| NPI | 1356878425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IA SP-0232) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: IA SP-0232) |
| 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: IA SP-0232) | |
| 2085R0203X Radiology, Therapeutic Radiology (Licence: IA SP-0232) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IA SP-0242) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TX BP10058864) | |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: IA SP-0232) | |
| Enumeration Date | 2017-05-18 |
| Last Update Date | 2019-07-15 |