| NPI | 1285074104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IL 036139638) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA 470981) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IN 01082448A) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: PA 470981) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT203607) | |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2024-09-12 |