| NPI | 1821044553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME82942) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME 82942) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA G61922) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA G61922) | |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2026-09-29 |