| NPI | 1821350836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NC 2016-01397) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: HI MD-20587) |
| Enumeration Date | 2012-06-14 |
| Last Update Date | 2023-02-01 |