| NPI | 1215928882 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME122178) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: FL ME122178) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: SC 27553) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TX L1173) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: PA MD453589) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MD D48191) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: AR E-11049) | |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2024-01-02 |