| NPI | 1083155055 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL OS22740) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IL 036.152528) |
| Enumeration Date | 2017-03-10 |
| Last Update Date | 2025-11-14 |