| NPI | 1457504268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NC 2014-02054) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CO DR.0057455) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CO DR.0057455) | |
| Enumeration Date | 2008-10-24 |
| Last Update Date | 2023-11-17 |