| NPI | 1184062283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IA MD-46057) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IA 46057) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: WA MD60750923) | |
| 208600000X Surgery (Licence: IA R-9800) | |
| Enumeration Date | 2013-06-11 |
| Last Update Date | 2023-11-22 |