| NPI | 1710166731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: ME 018589) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD425916) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 43516) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 094482) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME98287) | |
| Enumeration Date | 2007-10-26 |
| Last Update Date | 2016-07-22 |