| NPI | 1770545949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IA MD-47096) |
| Additional Taxonomies | 207UN0902X Nuclear Medicine, Nuclear Imaging & Therapy (Licence: WI 44289) |
| 2085B0100X Radiology, Body Imaging (Licence: IA MD-47096) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 44289) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IA MD-47096) | |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: IA MD-47096) | |
| Enumeration Date | 2006-04-04 |
| Last Update Date | 2022-09-23 |