| NPI | 1508081530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301082320) |
| Additional Taxonomies | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: CA A100702) |
| 2085R0001X Radiology, Radiation Oncology (Licence: CA A100702) | |
| 2085B0100X Radiology, Body Imaging (Licence: CA A100702) | |
| 2085N0700X Radiology, Neuroradiology (Licence: CA A100702) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A100702) | |
| 2085R0203X Radiology, Therapeutic Radiology (Licence: CA A100702) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA A100702) | |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: CA A100702) | |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2023-10-14 |