| NPI | 1356345680 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CO DR.0044004) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX J2121) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: HI MD17552) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 25137) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-36295) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 44004) | |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2024-03-29 |