| NPI | 1740440833 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085U0001X Radiology Diagnostic Ultrasound (Licence: TN 46796) |
| Additional Taxonomies | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: CO 29472) |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: TN 46796) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: TN 46796) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: CO 29472) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: OH 35.093299) | |
| Enumeration Date | 2008-06-11 |
| Last Update Date | 2024-02-12 |