| NPI | 1245723709 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: PA MD484528) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT214947) |
| Enumeration Date | 2018-06-10 |
| Last Update Date | 2024-05-20 |