| NPI | 1023248648 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME112396) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.005482) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME112396) | |
| Enumeration Date | 2009-07-16 |
| Last Update Date | 2024-02-19 |