| NPI | 1699701011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL OS11113) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: NC 2004-00278) |
| 2085B0100X Radiology, Body Imaging (Licence: FL OS1113) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2004-00278) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL OS11113) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NC 2004-00278) | |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2022-09-07 |