| NPI | 1932198652 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: AZ 30288) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO 47637) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MT 12685) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 30288) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MT 12685) | |
| Enumeration Date | 2005-10-14 |
| Last Update Date | 2022-08-19 |