| NPI | 1033202536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TX U5598) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: DE C1-0026240) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: WY 10974A) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CO DR.0044137) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NE 30092) | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2025-08-14 |