| NPI | 1013477884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NE 36962) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4351047263) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IA MD-54992) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036170893) | |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2026-08-03 |