| NPI | 1336126721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NV 12283) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036116322) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NV 12283) | |
| 2471C3402X Radiologic Technologist, Radiography (Licence: CA A82742) | |
| Enumeration Date | 2005-12-27 |
| Last Update Date | 2024-04-30 |