| NPI | 1467468868 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CO DR.0033145) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NE 23089) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: WY 7649A) | |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2022-03-18 |