| NPI | 1598780884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 200300259) |
| Additional Taxonomies | 2086S0129X (Licence: NC 200300259) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NC 2003-00259) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2026-04-09 |