| NPI | 1417175829 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: CO DR.0055706) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: NC 200400044) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: OR 28255) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: CO DR.0055706) | |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2022-12-15 |