| NPI | 1265870844 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IA MD-46245) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: AZ 50746) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IA MD-46245) | |
| Enumeration Date | 2013-06-05 |
| Last Update Date | 2021-08-19 |