| NPI | 1164743332 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: CO DR.0058412) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: NE 29919) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: HI MD19145) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: WI 63515) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: KS 04-39903) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: CO 58412) | |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2023-11-17 |