| NPI | 1942261631 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085U0001X Radiology, Diagnostic Ultrasound (Licence: VA 0101223831) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME98093) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME98093) | |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2016-07-13 |