| NPI | 1427019934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology |
| Additional Taxonomies | 2085R0204X Radiology Vascular & Interventional Radiology |
| Enumeration Date | 2006-04-01 |
| Last Update Date | 2007-07-08 |