| NPI | 1386828341 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: TX Q2457) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036119455) |
| Enumeration Date | 2007-12-26 |
| Last Update Date | 2016-08-02 |