| NPI | 1154354546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CO DR.0027075) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NE 20589) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: WY 7643A) | |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2022-03-18 |