| NPI | 1841495181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: PA MD445009) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: PA MD445009) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: DE C1-0009981) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: NJ 25MA09095200) | |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: DE C1-0009981) | |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: NJ 25MA09095200) | |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2020-01-02 |