| NPI | 1265795967 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME155460) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 55910) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 9407933) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036151041) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TX Q1454) | |
| Enumeration Date | 2012-06-19 |
| Last Update Date | 2024-05-06 |