| NPI | 1881796290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME97470) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: PR 13541) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME97470) | |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2025-08-01 |