| NPI | 1134410392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: OR MD181134) |
| Additional Taxonomies | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: VA 0101254234) |
| Enumeration Date | 2011-04-22 |
| Last Update Date | 2023-10-12 |