| NPI | 1982792818 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: DE C1-0009394) |
| Additional Taxonomies | 2085N0700X Radiology Neuroradiology (Licence: DE C1-0009394) |
| 2085N0904X Radiology Nuclear Radiology (Licence: DE C1-0009394) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: MD D0068887) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: MA 230305) | |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2023-11-30 |