| NPI | 1770558496 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TN 54593) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 217086) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 24890) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 56250) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-39312) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: HI MD18855) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MA 217086) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NE 24890) | |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2023-01-19 |