| NPI | 1528555869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME19350) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TN 63753) |
| Enumeration Date | 2018-04-20 |
| Last Update Date | 2026-05-27 |