| NPI | 1710959515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: AL MD16329) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 00016329) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME91907) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 21518) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 43599) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 34321) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 32656) | |
| Enumeration Date | 2006-02-06 |
| Last Update Date | 2016-10-13 |