| NPI | 1740403583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: AL MD 29560) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: AL MD.29560) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2016-10-17 |