| NPI | 1588635684 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A85990) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: CA A85992) |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: CA A85990) | |
| 2085B0100X Radiology, Body Imaging (Licence: CA A85990) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD60491574) | |
| Enumeration Date | 2006-01-28 |
| Last Update Date | 2016-12-27 |