| NPI | 1750517520 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TX Q7246) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NC 2017-01185) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME126365) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: VA 0101263069) | |
| Enumeration Date | 2009-06-05 |
| Last Update Date | 2022-08-19 |