| NPI | 1518926351 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: FL ME63973) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: FL ME63973) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: WA MD61413006) | |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2024-08-15 |