| NPI | 1194455337 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: VA 0116037614) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ND RL18701) |
| Enumeration Date | 2022-06-11 |
| Last Update Date | 2024-06-15 |