| NPI | 1568782233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: PA MD466223) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: PA MD466223) |
| Enumeration Date | 2010-06-04 |
| Last Update Date | 2019-02-28 |