| NPI | 1073932984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: PA MD467428) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: PA MD467428) |
| Enumeration Date | 2014-04-08 |
| Last Update Date | 2023-11-17 |