| NPI | 1487276036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: PA MT234895) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125075920) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: IL 125075920) | |
| Enumeration Date | 2020-05-16 |
| Last Update Date | 2025-06-26 |