| NPI | 1659310266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: MD D43396) |
| Additional Taxonomies | 2085B0100X Radiology Body Imaging (Licence: MD D43396) |
| 2085D0003X Radiology Diagnostic Neuroimaging (Licence: MD D43396) | |
| 2085N0904X Radiology Nuclear Radiology (Licence: MD D43396) | |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: MD D43396) | |
| 2085U0001X Radiology Diagnostic Ultrasound (Licence: MD D43396) | |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2020-01-23 |