| NPI | 1457309692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME126598) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 050160) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: GA 050160) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: ID M-11566) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: UT 8048800-1205) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME126598) | |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2016-01-29 |