| NPI | 1396793386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: NC 9801491) |
| Additional Taxonomies | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: NC 9801491) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2016-06-24 |