| NPI | 1841729431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: AZ 56935) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: AZ 2085R0202X) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: AZ 56935) | |
| 208600000X Surgery (Licence: AZ R76343) | |
| Enumeration Date | 2017-06-07 |
| Last Update Date | 2023-11-20 |