| NPI | 1003888173 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX H8342) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TX H8342) |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: TX H8342) | |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2019-09-23 |