| NPI | 1437598422 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: UT 11322555-1205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL35812) |
| Enumeration Date | 2013-06-23 |
| Last Update Date | 2020-09-01 |