| NPI | 1538128939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: SC 20153) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: GA 059683) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME79529) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 059683) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME79529) | |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2018-11-13 |