| 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) | 
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME156759) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MD D67715) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: DE C1-0012876) | |
| Enumeration Date | 2008-04-24 | 
| Last Update Date | 2024-06-05 |