| NPI | 1679523260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085N0700X Radiology, Neuroradiology (Licence: TX q0605) |
| Additional Taxonomies | 2085N0700X Radiology, Neuroradiology (Licence: TN 34681) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TN 34681) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TX Q0605) | |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2020-03-02 |