| NPI | 1225448616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA A182862) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CO DR.0071446) |
| Enumeration Date | 2014-05-06 |
| Last Update Date | 2025-09-10 |