| NPI | 1720058951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX K5749) |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: TX K5749) |
| 207UN0902X Nuclear Medicine, Nuclear Imaging & Therapy (Licence: TX K5749) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TX K5749) | |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2023-11-07 |