| NPI | 1447276225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: GA 053430) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD027085E) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: PA MD027085E) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2012-07-27 |