| NPI | 1598977076 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL OS11665) | 
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: DE C70002983) | 
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL OS11665) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA OS013961) | |
| Enumeration Date | 2007-05-04 | 
| Last Update Date | 2023-11-17 |