| NPI | 1295730349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MN 38581) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MN 38581) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: WI 45851-20) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GU MTL-2025-010) | |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2025-09-16 |