| NPI | 1821229709 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AR E-9740) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2016007047) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NM MD2020-0269) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MO 2016007047) | |
| Enumeration Date | 2009-07-27 |
| Last Update Date | 2021-06-22 |