| NPI | 1528440690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: WI 75569-20) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IL 036151947) |
| Enumeration Date | 2015-06-24 |
| Last Update Date | 2026-01-28 |