| NPI | 1528102670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX M2147) |
| Additional Taxonomies | 2085R0203X Radiology, Therapeutic Radiology (Licence: TX M2147) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: OK 28219) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA A104505) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TX M2147) | |
| 2085N0700X Radiology, Neuroradiology (Licence: CO DR.0068713) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A104505) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0068713) | |
| 207T00000X Neurological Surgery (Licence: CA A104505) | |
| 2085D0003X Radiology, Diagnostic Neuroimaging (Licence: CA A104505) | |
| 2085N0700X Radiology, Neuroradiology (Licence: TX M2147) | |
| 2085N0700X Radiology, Neuroradiology (Licence: CA A104505) | |
| Enumeration Date | 2007-02-19 |
| Last Update Date | 2022-11-18 |