| NPI | 1245218601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085B0100X Radiology, Body Imaging (Licence: NC 98-01333) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 98-01333) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NC 98-01333) | |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2007-07-08 |