| NPI | 1700203627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CO DR.0073417) |
| Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: FL ME151548) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 278016) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TX Q7544) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME151548) | |
| Enumeration Date | 2014-03-28 |
| Last Update Date | 2024-05-20 |