| NPI | 1255315479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0015047) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: NC 9601446) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 9601446) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NC 9601446) | |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2008-05-15 |