| NPI | 1053517516 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: FL ME105648) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: FL ME 105648) |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2023-09-05 |