| NPI | 1689882730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: OR MD29258) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: VA 0101237463) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2021-01-28 |