| NPI | 1073745188 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NC 2021-01625) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01075180A) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036-139355) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IL 036-139355) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: VA 0101272977) | |
| Enumeration Date | 2009-08-23 |
| Last Update Date | 2023-04-27 |