| NPI | 1285654210 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN MD38784) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 054977) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TN 38784) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: GA 54977) | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2018-02-22 |