| NPI | 1780884874 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CO DR.0067118) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD425039) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: PA MD425039) | |
| Enumeration Date | 2007-07-18 |
| Last Update Date | 2021-11-24 |