| NPI | 1770927287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 33615) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: AL 33615) |
| 208D00000X General Practice (Licence: AL MD.33615) | |
| Enumeration Date | 2013-04-26 |
| Last Update Date | 2024-02-29 |