| NPI | 1922397710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TN 63461) |
| Additional Taxonomies | 2085N0700X (Licence: MO 2017009605) |
| 2085N0700X (Licence: AL 38728) | |
| 2085N0700X (Licence: TN 63461) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 63461) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 38728) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: AL 38728) | |
| Enumeration Date | 2011-03-31 |
| Last Update Date | 2024-01-02 |