| NPI | 1447783717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: AL 3717) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MS 31375) |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2024-07-01 |