| NPI | 1871790998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME122896) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 35.121731) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: OH 35.121731) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IL 036152210) | |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2025-08-13 |