| NPI | 1437341096 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD00047963) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 71632) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IL 036113880) | |
| Enumeration Date | 2007-08-16 |
| Last Update Date | 2025-07-24 |