| NPI | 1609023282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MA 1015353) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 1015353) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2009-00713) | |
| Enumeration Date | 2008-08-26 |
| Last Update Date | 2023-09-06 |