| NPI | 1467836213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: CO DR.0066379) |
| Additional Taxonomies | 2085D0003X Radiology Diagnostic Neuroimaging (Licence: CO DR.0066379) |
| 2085N0904X Radiology Nuclear Radiology (Licence: CO DR.0066379) | |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: CO DR.0066379) | |
| Enumeration Date | 2015-07-10 |
| Last Update Date | 2025-07-21 |