| NPI | 1538444674 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TX R2979) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IL 036135650) |
| Enumeration Date | 2011-10-20 |
| Last Update Date | 2024-06-28 |