| NPI | 1982706974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NV 13205) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: NY 235600) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: HI MD-23935-0) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 70805) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 235600) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA11924600) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NV 13205) | |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2024-11-15 |