| NPI | 1013446798 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2024-00812) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 009082) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: PA OS022164) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: GA 96403) | |
| Enumeration Date | 2017-06-07 |
| Last Update Date | 2025-08-07 |