| NPI | 1326718792 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: NM RN-71870) |
| Additional Taxonomies | 163WC0200X Registered Nurse Critical Care Medicine (Licence: NM RN-71870) |
| Enumeration Date | 2021-09-17 |
| Last Update Date | 2022-02-28 |