| NPI | 1477082592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: WY 16039A) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NE CP548) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CO CDR.0003594) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WY 16039A) | |
| Enumeration Date | 2017-06-12 |
| Last Update Date | 2024-06-17 |