| NPI | 1235471608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA A131676) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: CA A131676) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A131676) | |
| Enumeration Date | 2013-03-22 |
| Last Update Date | 2024-04-05 |