| NPI | 1740200187 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 108877) |
| Additional Taxonomies | 2085N0700X (Licence: MO 108877) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036101977) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IA MD-33964) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-28930) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD459547) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MO 108877) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 35173) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101240919) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WV 21052) | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2020-10-29 |