| NPI | 1033181839 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: AL 16370) |
| Additional Taxonomies | 2085N0700X Radiology Neuroradiology (Licence: AL 00016370) |
| 2085N0700X Radiology Neuroradiology (Licence: FL ME90475) | |
| 2085N0700X Radiology Neuroradiology (Licence: GA 038221) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: AL 00016370) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: FL ME90475) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: GA 038221) | |
| Enumeration Date | 2006-02-06 |
| Last Update Date | 2016-06-30 |