| NPI | 1891011383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CO DR.0057197) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0057197) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-45380) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NE 33502) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: HI MD22022) | |
| Enumeration Date | 2010-04-09 |
| Last Update Date | 2023-11-17 |