| NPI | 1043222334 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: ME 017660) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CO 42012) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: ME 017660) | |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2011-08-15 |