| NPI | 1992032577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: MO 2015021498) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301113085) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 303155) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: ND 16097) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MI 4301113085) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MO 2015021498) | |
| Enumeration Date | 2009-11-03 |
| Last Update Date | 2023-09-19 |