| NPI | 1316937717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA A51389) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CO DR.0036138) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IL 036097999) | |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2023-11-27 |