| NPI | 1598961187 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NC 2014-01746) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD445371) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2014-01746) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IA MD-45164) | |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2023-09-19 |