| NPI | 1871889527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CO DR.0060916) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OK 32489) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0060916) | |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2024-01-10 |