| NPI | 1578518171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: TN 44243) |
| Additional Taxonomies | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: AR C-8182) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2017-02-03 |