| NPI | 1942286661 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: CO 30434) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: NE 27274) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: CO 30434) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: HI MD21108) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: KS 04-43282) | |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2023-11-17 |