| NPI | 1750538252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TX R1225) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA A136221) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: WA MD61112562) | |
| 208D00000X General Practice (Licence: NE 25395) | |
| Enumeration Date | 2008-08-26 |
| Last Update Date | 2024-08-30 |