| NPI | 1356310387 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: IA DO-05072) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: OK 3485) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: ND PT13068) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: IA DO-05072) | |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: IA 05072) | |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: OK 3485) | |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: VA 0102206280) | |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: ND PT13068) | |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2022-03-24 |