| NPI | 1457442063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: CA G39182) |
| Additional Taxonomies | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: CA G39182) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2015-08-19 |