| NPI | 1497730469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: MS 24412) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: GA 049371) |
| 2085R0204X Radiology Vascular & Interventional Radiology (Licence: GA 049371) | |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2022-07-21 |