| NPI | 1346733102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: ME MD28111) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: RI MD18600) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: ME MD28111) | |
| Enumeration Date | 2018-06-07 |
| Last Update Date | 2024-07-09 |