| NPI | 1780874917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: VA 0101245001) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116019242) |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: VA 0101245001) | |
| 2085B0100X Radiology Body Imaging (Licence: VA 0101245001) | |
| 2085D0003X Radiology Diagnostic Neuroimaging (Licence: VA 0101245001) | |
| 2085U0001X Radiology Diagnostic Ultrasound (Licence: VA 0101245001) | |
| 2085N0700X Radiology Neuroradiology (Licence: VA 0101245001) | |
| 2085N0904X Radiology Nuclear Radiology (Licence: VA 0101245001) | |
| 2085P0229X Radiology Pediatric Radiology (Licence: VA 0101245001) | |
| 2085R0001X Radiology Radiation Oncology (Licence: VA 0101245001) | |
| 2085R0205X Radiology Radiological Physics (Licence: VA 0101245001) | |
| 2085R0203X Radiology Therapeutic Radiology (Licence: VA 0101245001) | |
| 207U00000X Nuclear Medicine (Licence: VA 0101245001) | |
| Enumeration Date | 2007-07-25 |
| Last Update Date | 2013-11-22 |