| NPI | 1053519298 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301074897) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: MI 4301074897) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301074897) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MI 4301074897) | |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2023-11-25 |