| NPI | 1497739205 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: FL ME110783) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: MO 2002008173) |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: MO 2002008173) | |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: IL 036104926) | |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: NE 21175) | |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2023-01-13 |