| NPI | 1245494467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MD D0088406) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: DC MD038017) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: VA 0101253603) | |
| Enumeration Date | 2008-07-16 |
| Last Update Date | 2023-12-03 |