| NPI | 1699060442 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CO DR.0058435) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0058435) |
| 2085N0904X (Licence: CO DR.0058435) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IL 036-139755) | |
| Enumeration Date | 2011-06-09 |
| Last Update Date | 2025-04-02 |