| NPI | 1154379428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TX N1349) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: WI 44460) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IL 036106450) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX N1349) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036106450) | |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2024-03-07 |