| NPI | 1730445016 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: UT 12527536-1205) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: IA MD-44241) |
| 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: IA MD-44241) | |
| 2085H0002X Radiology, Hospice and Palliative Medicine (Licence: IA MD-44241) | |
| 2085N0700X Radiology, Neuroradiology (Licence: IA MD-44241) | |
| 2085N0904X Radiology, Nuclear Radiology (Licence: IA MD-44241) | |
| 2085P0229X Radiology, Pediatric Radiology (Licence: IA MD-44241) | |
| 2085R0001X Radiology, Radiation Oncology (Licence: IA MD-44241) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IA MD-44241) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ R74141) | |
| 2085R0203X Radiology, Therapeutic Radiology (Licence: IA MD-44241) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IA MD-44241) | |
| 2085R0205X Radiology, Radiological Physics (Licence: IA MD-44241) | |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: IA MD-44241) | |
| Enumeration Date | 2012-04-11 |
| Last Update Date | 2022-01-13 |