| NPI | 1518054535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: FL ME96728) |
| Additional Taxonomies | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: GA 57939) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2025-08-18 |