| NPI | 1780177857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: IA MD-52892) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: IA R-11334) |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2024-05-20 |