| NPI | 1487812236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA A133522) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 255094) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MA 255094) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TX 45606) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TX Q9470) | |
| Enumeration Date | 2008-05-29 |
| Last Update Date | 2023-12-22 |