| NPI | 1528022258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX H8469) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TX H8469) |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: TX H8469) | |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2025-02-21 |