| NPI | 1417274481 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: FL ME129372) |
| Additional Taxonomies | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: NY 2804361) |
| Enumeration Date | 2010-04-29 |
| Last Update Date | 2021-11-23 |