| NPI | 1508840018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0071780) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 33277) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA 50685) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CO DR.0071780) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD00039655) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 63044) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: AZ 33277) | |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2023-10-31 |