| NPI | 1134184310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101282354) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35086213) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD430255) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: VA 0101282354) | |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2024-08-14 |