| NPI | 1275616849 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301076827) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 103320) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: ME MD29005) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MI 4301076827) | |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2025-07-07 |