| NPI | 1083633267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NY 231711) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NM TM2023-1133) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2024-11-07 |