| NPI | 1891748653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 32234) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: TN MD0000032234) |
| 2085N0904X Radiology, Nuclear Radiology (Licence: TN MD0000032234) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TN MD0000032234) | |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: TN MD0000032234) | |
| 207UN0902X Nuclear Medicine, Nuclear Imaging & Therapy (Licence: TN MD0000032234) | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2021-03-09 |