| NPI | 1649614926 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: VA 0101258219) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MD D0095111) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME173185) | |
| Enumeration Date | 2013-04-17 |
| Last Update Date | 2025-09-16 |