| NPI | 1104188879 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: ID M-14181) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MT MED-PHYS-LIC-64044) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD220544) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-49767) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX V1970) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0076404) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME168707) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NH RT3082) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: ID M-14181) | |
| Enumeration Date | 2012-06-08 |
| Last Update Date | 2026-02-27 |