| NPI | 1740406149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: MT MED-PHYS-LIC-105069) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: IA 36189) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: KS 04-32462) | |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: KS 04-32462) | |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: MO 2008009083) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: NE 23289) | |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2022-07-07 |