| NPI | 1821294695 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CO DR.0059353) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 30406) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-40540) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: HI MD19441) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: ND 12300) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 59353) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: ND 12300) | |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2023-11-17 |