| NPI | 1154522738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL OS10705) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 74268) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL OS10705) | |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2025-10-02 |