| NPI | 1427220235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: VA 0101290219) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME126929) |
| Enumeration Date | 2008-04-01 |
| Last Update Date | 2026-09-01 |