| NPI | 1720121684 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: OK 22334) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IL 036163488) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 22334) | |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2023-05-02 |