| NPI | 1720145634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IA MD-34964) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IA 34964) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 23324) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 104349) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 52264) | |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2023-11-22 |