| NPI | 1043506066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NH 3327) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NH 3327) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NH 3327) | |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2019-04-22 |