| NPI | 1972715282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: ND 12274) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MT 34889) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: ND 12274) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 62008-20) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MT 34889) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AK MEDS8056) | |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2023-11-29 |