| NPI | 1689069296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA A172277) |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: LA 302629) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A172277) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX BP10057591) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: LA 302629) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: LA 302629) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NM NotYetAvailable) | |
| 208600000X Surgery (Licence: LA PGY.202841) | |
| 208D00000X General Practice (Licence: LA 302629) | |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2021-06-17 |