| NPI | 1457549198 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: AL 37655) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 44375) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TN 44375) | |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2023-05-02 |