| NPI | 1689641136 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME101445) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME 101445) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GU M-2258) | |
| Enumeration Date | 2006-03-03 |
| Last Update Date | 2025-06-26 |