| NPI | 1629212055 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME137984) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME137984) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MA 239045) | |
| Enumeration Date | 2009-04-29 |
| Last Update Date | 2024-01-03 |