| NPI | 1427091586 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: AZ 36971) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA A94703) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A94703) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 36971) | |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2008-05-27 |