| NPI | 1144575788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TX R4320) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125019034) |
| Enumeration Date | 2012-07-19 |
| Last Update Date | 2022-09-29 |