| NPI | 1689871709 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: LA 206371) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: SC 29762) |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2016-06-16 |