| NPI | 1942535059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X (Licence: FL ME156411) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME156411) |
| Enumeration Date | 2009-10-07 |
| Last Update Date | 2025-08-21 |