| NPI | 1437440492 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TX P6675) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: UT 9759577-1205) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: UT 9759577-1205) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: UT 9759577-1205) | |
| Enumeration Date | 2011-04-26 |
| Last Update Date | 2019-06-27 |