| NPI | 1487645800 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 21871) |
| Additional Taxonomies | 208VP0000X (Licence: OK 21871) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: OK 21871) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: OK 21871) | |
| Enumeration Date | 2005-11-03 |
| Last Update Date | 2026-03-24 |