| NPI | 1821103714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: AK 104823) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A108092) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA A108092) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME112250) | |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2019-08-16 |