| NPI | 1275920613 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: CO DR.0066120) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: CO DR.0066120) |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: MO 2016010262) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: MO 2016010262) | |
| Enumeration Date | 2015-04-23 |
| Last Update Date | 2024-10-04 |