| NPI | 1609498070 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: OK 50454) |
| Additional Taxonomies | 207UN0902X Nuclear Medicine, Nuclear Imaging & Therapy (Licence: OK 50454) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 50454) | |
| Enumeration Date | 2020-05-08 |
| Last Update Date | 2026-08-05 |