| NPI | 1083814297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A85484) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD28077) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AK 6251) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: PA MT190680) | |
| Enumeration Date | 2007-07-25 |
| Last Update Date | 2021-12-01 |