| NPI | 1326345372 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL OS14794) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL OS14794) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036141043) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IL 036141043) | |
| Enumeration Date | 2011-02-26 |
| Last Update Date | 2022-07-21 |