| NPI | 1255431235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CO DR.0048923) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-38597) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 28964) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 48923) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: HI MD18441) | |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2023-11-17 |