| NPI | 1700232105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: OR MD186503) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10056213) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: OR MD186503) | |
| Enumeration Date | 2016-05-04 |
| Last Update Date | 2023-12-13 |