| NPI | 1144227331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME133543) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NY 213214) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 213214) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME133543) | |
| Enumeration Date | 2005-07-01 |
| Last Update Date | 2021-08-04 |