| NPI | 1144647272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: IA MD-50885) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: IA MD-50885) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: FL ME145423) | |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2023-04-05 |