| NPI | 1891012696 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TN 54144) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 54144) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 31315) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: AZ 64788) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: AL 31315) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: KY 49096) | |
| Enumeration Date | 2010-05-03 |
| Last Update Date | 2023-02-15 |