| NPI | 1972529584 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TX L6765) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD467367) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX L6765) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 52523) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301118907) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.136651) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101267605) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: PA MD467367) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: KY 52523) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: OH 35.136651) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: VA 0101267605) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MI 4301118907) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: LA 330930) | |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2024-05-22 |