| NPI | 1467400580 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: AZ 56442) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IL 036106011) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA G075762) | |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2022-01-05 |