| NPI | 1639229263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: KS 0430148) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MO 2011007624) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2025-12-15 |