| NPI | 1841245149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: CA C171331) |
| Additional Taxonomies | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: FL ME141354) |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: NY 001841) | |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: NJ 25MA10476200) | |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: NY 255800) | |
| 208D00000X General Practice (Licence: AZ 62507) | |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2025-08-27 |