| NPI | 1780641969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: FL ME 38707) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL ME38707) |
| Enumeration Date | 2006-04-29 |
| Last Update Date | 2015-12-07 |