| NPI | 1982644928 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NC 2013-0900) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101245373) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: SC 36769) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2013-00900) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: SC 36769) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: VA 0101245373) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NC 2013-00900) | |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2023-12-20 |