| NPI | 1023190097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2007-01814) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA a90220) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IN 01055825A) | |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2011-09-30 |