| NPI | 1194916866 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NY 268265) |
| Additional Taxonomies | 174400000X Specialist (Licence: IN 01063987A) |
| Enumeration Date | 2007-08-07 |
| Last Update Date | 2022-05-31 |