| NPI | 1427580919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: GA 95629) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: DC MD210002562) |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2023-06-02 |