| NPI | 1003045022 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: CO DR.0058628) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: MI 5101018391) |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: CO DR.0058628) | |
| 208D00000X General Practice (Licence: MI 5101018391) | |
| Enumeration Date | 2009-07-12 |
| Last Update Date | 2022-09-09 |