| NPI | 1306003579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 32589) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: ND 22084) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: AL 32589) | |
| Enumeration Date | 2008-05-16 |
| Last Update Date | 2025-04-14 |