| NPI | 1205824497 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: GA 32463) |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2022-07-21 |