| NPI | 1760430029 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME144270) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MS 26915) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TN 53980) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: AL MD44599) | |
| 202K00000X Phlebology (Licence: FL ME144270) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: AR E-17494) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: AZ 59586) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: PA MD055735L) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TX S1850) | |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2025-10-22 |