| NPI | 1144395187 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NV DO2026) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: LA MD.025543) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101245368) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX P1150) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: VA 0101245368) | |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2021-04-01 |