| NPI | 1285878728 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TX Q4581) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX Q4581) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01073728A) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 54736-20) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IN 01073728A) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: WI 54736-20) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: OR MD179412) | |
| Enumeration Date | 2009-04-28 |
| Last Update Date | 2022-01-25 |