| NPI | 1639312598 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2014009240) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 0435348) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 52682) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101258263) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WV 26330) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MO 2014009240) | |
| Enumeration Date | 2009-04-08 |
| Last Update Date | 2020-10-29 |