| NPI | 1548965098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL 1886) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL 1886) |
| 2085B0100X Radiology, Body Imaging (Licence: FL 1886) | |
| Enumeration Date | 2023-04-04 |
| Last Update Date | 2023-04-04 |