| NPI | 1043714413 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL OS16404) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL OS16404) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL OS16404) | |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2024-06-19 |