NPI | 1750304457 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101258827) |
Additional Taxonomies | 2085U0001X Radiology, Diagnostic Ultrasound (Licence: IA MD-42771) |
2085B0100X Radiology, Body Imaging (Licence: IA MD-42771) | |
2085R0202X Radiology, Diagnostic Radiology (Licence: IA MD-42771) | |
2085R0202X Radiology, Diagnostic Radiology (Licence: SC 22732) | |
Enumeration Date | 2006-07-25 |
Last Update Date | 2025-09-24 |