| NPI | 1811301021 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL OS21472) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GU EMTL-2022-029) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NY 309662) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MB11397100) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2022030300) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GU DO-0117) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 0546553) | |
| Enumeration Date | 2014-06-16 |
| Last Update Date | 2024-11-06 |