| NPI | 1467490797 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D47346) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: MD D47346) |
| 2085B0100X Radiology, Body Imaging (Licence: PA MD051244L) | |
| 2085B0100X Radiology, Body Imaging (Licence: WV 18148) | |
| 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: MD D47346) | |
| 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: PA MD051244L) | |
| 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: WV 18148) | |
| 2085N0904X (Licence: MD D47346) | |
| 2085N0904X (Licence: PA MD051244L) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD051244L) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WV 18148) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MD D47346) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: PA MD051244L) | |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: MD D47346) | |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: PA MD051244L) | |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2020-01-23 |