| NPI | 1275893281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: WI 23054) |
| Additional Taxonomies | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: IL 036.123715) |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: SD 8485) | |
| Enumeration Date | 2012-05-23 |
| Last Update Date | 2023-07-27 |