| NPI | 1497997050 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: WI 54493) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AR E-16014) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 56069) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD479586) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: HI MD-23029) | |
| Enumeration Date | 2009-03-29 |
| Last Update Date | 2023-12-28 |