| NPI | 1699803940 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: NC 2024-01201) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 056690) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NY 208490-1) | |
| 208600000X Surgery (Licence: VA 0101232159) | |
| 2086S0129X (Licence: GA 056690) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: GA 056690) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NC 2024-01201) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: VA 0101232159) | |
| 208600000X Surgery (Licence: NY 208490-1) | |
| 208600000X Surgery (Licence: NC 2024-01201) | |
| 2086S0129X (Licence: VA 0101232159) | |
| 2086S0129X (Licence: NY 208490-1) | |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2026-02-15 |