| NPI | 1265486500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301072271) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: MI 4301072271) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME162110) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MI 4301072271) | |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2023-06-27 |