| NPI | 1740785922 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: MT MED-PHYS-LIC-136393) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX U5231) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: TX U5231) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: MT MED-PHYS-LIC-136393) | |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2025-07-10 |