| NPI | 1184731283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA RHL00165925) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A71688) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA A71688) | |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2023-09-29 |