| NPI | 1972558203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA A92815) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IA 38640) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: RI MD11673) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IL 036118482) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IN 01061803A) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: WA MD00048432) | |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2023-05-25 |