| NPI | 1982676664 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME76550) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 00026333) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: TX J8715) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 053805) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: AL 00026333) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME76550) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TX J8715) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: GA 053805) | |
| Enumeration Date | 2006-02-06 |
| Last Update Date | 2011-11-02 |