| NPI | 1760430029 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TX S1850) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TN 53980) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: PA MD055735L) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: AL MD44599) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: AZ 59586) | |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2023-10-04 |