| NPI | 1013599919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0074241) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CO DR.0074241) |
| 2085N0904X (Licence: CO DR.0074241) | |
| Enumeration Date | 2021-04-21 |
| Last Update Date | 2025-08-01 |