| NPI | 1447400890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: RI md13941) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 246119) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: RI md13941) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MA 1015841) | |
| Enumeration Date | 2008-09-23 |
| Last Update Date | 2024-10-23 |