| NPI | 1982706974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: NV 13205) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: HI MD-23935-0) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: AZ 70805) | |
| 2085B0100X Radiology Body Imaging (Licence: NY 235600) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: NY 235600) | |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: NV 13205) | |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2024-05-16 |