| NPI | 1093790487 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 36777) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD459606) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WV 21050) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 45140-20) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 0429898) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101241014) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MO 36777) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036077113) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 37085) | |
| Enumeration Date | 2005-12-08 |
| Last Update Date | 2020-10-29 |