| NPI | 1124153655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA A104050) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.084967) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 36117625) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A104050) | |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2015-07-29 |