| NPI | 1306825252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X (Licence: NC 200400963) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NC 200400963) |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2016-09-02 |