| NPI | 1386869535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: GA 070519) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AR E-6673) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2012-00039) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MS 2113) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 44213) | |
| Enumeration Date | 2007-04-14 |
| Last Update Date | 2019-04-15 |