| NPI | 1457511479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: SC 30898) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL30898) |
| Enumeration Date | 2008-06-12 |
| Last Update Date | 2020-10-15 |