| NPI | 1831192285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: TN 37222) |
| Additional Taxonomies | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: MS 17708) |
| 2085R0202X Radiology Diagnostic Radiology (Licence: TN 37222) | |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2023-12-05 |