| NPI | 1326029950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: OR MD26590) |
| Additional Taxonomies | 202K00000X (Licence: OR MD26590) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD26590) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: WI 3067) | |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2023-06-07 |