| NPI | 1336188945 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: PA MD027999E) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD027999E) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2021-04-29 |