| NPI | 1083844534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: TX R1715) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301089532) |
| Enumeration Date | 2009-07-18 |
| Last Update Date | 2022-07-21 |