| NPI | 1255533857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NV 15612) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 77502) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101281329) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA A116663) | |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2024-05-29 |