| NPI | 1588755623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CO DR.0049655) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA ML20008627) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-36320) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: HI MD17634) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 26106) | |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2024-03-31 |