| NPI | 1992294938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME141579) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME141579) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: AK 212574) | |
| Enumeration Date | 2018-05-04 |
| Last Update Date | 2024-05-21 |