| NPI | 1497935837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: AL MD33249) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: CA A119999) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 46579) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A119999) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KY C1441) | |
| Enumeration Date | 2007-11-13 |
| Last Update Date | 2025-02-04 |