| NPI | 1740411339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: AR E-11727) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT195454) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: PA MT195454) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: UT 9702737-1205) | |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: IL 036134980) | |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: KY TP540) | |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: UT 9702737) | |
| Enumeration Date | 2009-07-31 |
| Last Update Date | 2022-08-26 |