| NPI | 1467471284 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: UT 291097-1205) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: UT 291097-1205) |
| 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: UT 291097-1205) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: UT 291097-1205) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NV 11176) | |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2021-08-12 |