| NPI | 1437323557 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: ND 11886) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: AZ 81060) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: ND PT 11886) | |
| Enumeration Date | 2008-04-18 |
| Last Update Date | 2011-11-29 |