| NPI | 1073833125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: PA MD457026) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DE C7-0004541) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-06-10 |
| Last Update Date | 2023-08-08 |