| NPI | 1073849535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX Q0960) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10034493) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 258600) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MA 258600) | |
| Enumeration Date | 2009-10-19 |
| Last Update Date | 2018-11-30 |