| NPI | 1033180203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TX P9260) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA G87607) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX P9260) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA G87607) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036108714) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IL 036108714) | |
| 202K00000X (Licence: CA G87607) | |
| 202K00000X (Licence: TX P9260) | |
| 202K00000X (Licence: IL 036108714) | |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2016-02-17 |