| NPI | 1013053073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: GA 59098) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101234213) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 59098) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 200501136128939) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: VA 0101234213) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NC 200501136128939) | |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2023-11-20 |