| NPI | 1437335833 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CO DR.0075514) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME111363) |
| 2085R0203X Radiology, Therapeutic Radiology (Licence: FL ME111363) | |
| 2085N0700X (Licence: FL ME111363) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME111363) | |
| 2085N0700X (Licence: CO DR.0075514) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0075514) | |
| Enumeration Date | 2008-01-15 |
| Last Update Date | 2025-09-10 |