| NPI | 1962617274 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: PA MD460710) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: FL ME124556) |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: FL ME124556) | |
| 2085R0202X Radiology Diagnostic Radiology (Licence: PA MD460710) | |
| 207R00000X Internal Medicine (Licence: FL ME124556) | |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2023-11-17 |