| NPI | 1134437726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MA 1016208) |
| Additional Taxonomies | 2085P0229X Radiology, Pediatric Radiology (Licence: IA MD-44831) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 1016208) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IA MD-44831) | |
| Enumeration Date | 2010-09-17 |
| Last Update Date | 2025-04-07 |