| NPI | 1770872665 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: DC MD042072) | 
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: DC MD042072) | 
| Enumeration Date | 2011-03-31 | 
| Last Update Date | 2022-05-10 |