| NPI | 1750324232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NM MD2002-0304) |
| Additional Taxonomies | 174400000X Specialist (Licence: NM 20020304) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NM MD2002-0304) | |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2019-12-30 |