| NPI | 1528030293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: AL MD 25609) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: AL 00025609) |
| Enumeration Date | 2006-02-06 |
| Last Update Date | 2016-10-14 |