| NPI | 1033165865 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME105071) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: DE C1-0008029) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME105071) | |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2016-12-13 |