| NPI | 1225290380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: IA MD-53250) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: ND 21172) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TX P4697) | |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2024-10-14 |