| NPI | 1891737904 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL 163808) |
| Additional Taxonomies | 2085N0904X Radiology, Nuclear Radiology (Licence: KY 25364) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 25364) | |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: KY 25364) | |
| 2085B0100X Radiology, Body Imaging (Licence: KY 25364) | |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2023-11-09 |