| NPI | 1871545269 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD00046123) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GU MC-164) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WY 10414A) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2015044233) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: ND 15139) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: WA MD00046123) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2023-12-28 |