| NPI | 1477507416 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: KY 52467) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01061400A) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IN 01061400A) | |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2021-09-27 |