| NPI | 1225290380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IA MD-53250) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TX P4697) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WY 17046C) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 77094) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: ND 21172) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GU MC-238) | |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2025-09-23 |