| NPI | 1649689282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MO 2015003759) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 40475) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 0447032) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2015003759) | |
| Enumeration Date | 2014-08-07 |
| Last Update Date | 2023-11-20 |