| NPI | 1639387624 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME108929) |
| Additional Taxonomies | 2086S0129X (Licence: FL ME108929) |
| 174400000X Specialist (Licence: FL ME108929) | |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2023-08-10 |