| NPI | 1528328754 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: ND 15043) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TN 55838) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: IN 11017225A) | |
| 208600000X Surgery (Licence: TX BP10043384) | |
| Enumeration Date | 2012-05-22 |
| Last Update Date | 2021-05-04 |