| NPI | 1407245301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MO 2019009749) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IA MD-46602) |
| Enumeration Date | 2015-01-15 |
| Last Update Date | 2026-02-23 |