| NPI | 1043745466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: CA A189914) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: CA A189914) |
| Enumeration Date | 2017-04-24 |
| Last Update Date | 2024-11-06 |