| NPI | 1033401849 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA A141867) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NY 282294) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A141867) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NY 282294) | |
| Enumeration Date | 2011-05-11 |
| Last Update Date | 2024-04-09 |