| NPI | 1538340344 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: CO DR.0064590) |
| Additional Taxonomies | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: NY 260748) |
| Enumeration Date | 2007-11-20 |
| Last Update Date | 2024-05-13 |