| NPI | 1184686933 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 226012) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IA MD-53590) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MA 226012) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IA MD-53590) | |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2024-12-17 |