| NPI | 1801039037 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NM MD2015-0066) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME107696) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NM MD2015-0066) | |
| Enumeration Date | 2009-04-17 |
| Last Update Date | 2016-06-06 |