| NPI | 1043266117 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MO 2007017236) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NV 6497) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 2007017236) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: KS 04-22603) | |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2022-03-24 |