| NPI | 1689765554 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MS 19869) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: AR C-5990) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2014-03-12 |