| NPI | 1477589406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD427504) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD00043924) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 118238) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: WA MD00043924) | |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2023-01-10 |