| NPI | 1790720779 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085B0100X Radiology, Body Imaging (Licence: MS 14181) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: AR E-0389) |
| 2085B0100X Radiology, Body Imaging (Licence: LA MD.200141) | |
| 2085B0100X Radiology, Body Imaging (Licence: GA 049069) | |
| 2085B0100X Radiology, Body Imaging (Licence: TN 693403) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MS 14181) | |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2013-10-17 |