| NPI | 1013916436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME154879) |
| Additional Taxonomies | 202K00000X Phlebology (Licence: FL ME154879) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: PA MD039322E) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MD D0066103) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NJ 25MA08762200) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: WA MD60158521) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA G88795) | |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2025-02-15 |