| NPI | 1205018595 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MT 20575) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01064573A) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MT 20575) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: ID M11263) | |
| Enumeration Date | 2007-11-29 |
| Last Update Date | 2020-09-22 |