| NPI | 1467615252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: AZ 48843) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: WY 14657C) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: GU MTL-2023-020) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: GU MC-184) | |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: ND 19383) | |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: AZ 48843) | |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2024-04-26 |