| NPI | 1902011588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: VA 0101266907) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101266907) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME104876) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME104876) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 40240) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2005-00589) | |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2024-08-12 |