| NPI | 1548218696 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 21382) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: SD 5585) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MO 2011027768) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NE 21382) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IA MD-33422) | |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2021-04-01 |