| NPI | 1326484114 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D91374) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: RI MD16629) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: PA MT204313) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: RI MD16629) | |
| Enumeration Date | 2013-05-20 |
| Last Update Date | 2021-07-26 |