| NPI | 1548492325 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TX T9317) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: GA 65781) |
| 2085N0700X Radiology, Neuroradiology (Licence: TX T9317) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: GA 65781) | |
| Enumeration Date | 2009-08-12 |
| Last Update Date | 2024-04-16 |