| NPI | 1518287176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: CO DR.0059052) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT197155) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: NE 30223) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: CO 59052) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: HI MD19435) | |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: FL ME 122718) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: KS 04-40380) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL ME122718) | |
| Enumeration Date | 2010-06-07 |
| Last Update Date | 2023-11-17 |