| NPI | 1750693800 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: VA 0101) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 244269) |
| Enumeration Date | 2010-07-06 |
| Last Update Date | 2018-02-07 |