| NPI | 1851562540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 41825) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: OH 35.091510) |
| 174400000X Specialist (Licence: KY 41825) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01062470A) | |
| Enumeration Date | 2008-03-20 |
| Last Update Date | 2024-06-13 |