| NPI | 1881758886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME100244) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: ZZ ME100244) |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2022-12-01 |