| NPI | 1548435290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: MD D67715) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: DE C1-0012876) |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: DE C1-0012876) | |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: MD D67715) | |
| Enumeration Date | 2008-04-24 |
| Last Update Date | 2021-02-15 |