| NPI | 1225054935 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: VT 042-0008419) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NC 26025) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NH 8593) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2007-07-08 |