| NPI | 1821117912 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IA DO-4506) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036-113497) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IA 4506) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 005042) | |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2023-11-22 |