| NPI | 1629339155 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: OR MD197126) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP02584) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: RI MD14849) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD197126) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MA 276816) | |
| Enumeration Date | 2012-05-31 |
| Last Update Date | 2023-12-11 |