| NPI | 1124281175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME138121) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME138121) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: GA 76547) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: OH 35.095903) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IL 036.123884) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MD D0073631) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NJ 25MA08338100) | |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2021-06-25 |