| NPI | 1750334884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: CO DR.0038758) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: HI MD17562) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: KS 04-36353) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: CO 38758) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: NE 25134) | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2024-03-31 |