| NPI | 1275979437 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0085589) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 192092) | 
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2020-04356) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NC 202004356) | |
| Enumeration Date | 2013-05-15 | 
| Last Update Date | 2024-03-11 |