| NPI | 1053435321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: OH 35.087689) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MD MD431732) |
| 174400000X Specialist (Licence: PA MD431732) | |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2024-06-26 |