| NPI | 1295077196 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CO DR.0072439) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NE 36210) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: WY 16941A) | |
| Enumeration Date | 2013-03-19 |
| Last Update Date | 2024-07-02 |