| NPI | 1083857627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CO DR.0071757) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME-114454) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TX Q3424) | |
| Enumeration Date | 2009-04-13 |
| Last Update Date | 2024-02-15 |