| NPI | 1306877824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: MO R5J19) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MO R5J19) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2025-04-17 |