| NPI | 1396163135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX S8769) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0102826) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 443471) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NV 26525) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35C.001818) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301512615) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME170445) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IL 036146084) | |
| Enumeration Date | 2014-03-30 |
| Last Update Date | 2025-08-26 |