| NPI | 1447486113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 52558) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101248124) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TN 52558) | |
| Enumeration Date | 2009-06-08 |
| Last Update Date | 2022-10-31 |