| NPI | 1588927602 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: AZ 54626) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT202797) |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2019-02-05 |