| NPI | 1225078488 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MO 114297) |
| Additional Taxonomies | 207UN0901X Nuclear Medicine, Nuclear Cardiology (Licence: MO 114297) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MO 114297) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: KS 0427371) | |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2022-02-16 |