| NPI | 1104938208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: CO DR.0050665) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: NE 26523) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: KS 04-36314) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: CO 50665) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: HI MD17508) | |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: WA MD00046721) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2024-03-29 |