| NPI | 1255931226 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AR E-1306) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: AR E-13016) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: AR E-13016) | |
| Enumeration Date | 2020-10-29 |
| Last Update Date | 2020-11-09 |