| NPI | 1093404345 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WI 100683-851) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: WI 100683-851) |
| Enumeration Date | 2023-05-03 |
| Last Update Date | 2024-06-11 |