NPI | 1922032119 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: VA 0101222158) |
Additional Taxonomies | 2085U0001X Radiology Diagnostic Ultrasound (Licence: VA 0101222158) |
2085B0100X Radiology Body Imaging (Licence: VA 0101222158) | |
2085N0700X Radiology Neuroradiology (Licence: VA 0101222158) | |
2085N0904X Radiology Nuclear Radiology (Licence: VA 0101222158) | |
2085P0229X Radiology Pediatric Radiology (Licence: VA 0101222158) | |
2085R0204X Radiology Vascular & Interventional Radiology (Licence: VA 0101222158) | |
Enumeration Date | 2006-07-11 |
Last Update Date | 2022-02-04 |