| NPI | 1003873951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: AL 27222) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TN 48054) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA 139824) | |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2024-02-26 |