| NPI | 1043471022 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: CA A151868) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: AR E-16696) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: CA A151868) | |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: AR E-16696) | |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2023-06-20 |