| NPI | 1528088242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: KY 34377) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 01053396A) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: KY 34377) | |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2024-11-12 |