| NPI | 1346248028 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME78629)  | 
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 53466)  | 
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME0078629)  | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101259162)  | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IL 036143094)  | |
| 207T00000X Neurological Surgery (Licence: IL 036143094)  | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME78629)  | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TN 53466)  | |
| Enumeration Date | 2005-07-07 | 
| Last Update Date | 2025-10-02 |