| NPI | 1154515716 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME110742) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME110742) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301084169) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IL 036.123106) | |
| Enumeration Date | 2007-08-28 |
| Last Update Date | 2026-08-11 |