| NPI | 1518923416 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: GA 027795) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: GA 027795) |
| 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: GA 027795) | |
| 2085N0700X (Licence: GA 027795) | |
| 2085N0904X (Licence: GA 027795) | |
| 2085P0229X Radiology, Pediatric Radiology (Licence: GA 027795) | |
| 2085R0001X (Licence: SC 29315) | |
| 2085R0203X Radiology, Therapeutic Radiology (Licence: GA 027795) | |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: GA 027795) | |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2025-06-10 |