| NPI | 1831676030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: OR MD222073) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125073397) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA 166191) | |
| Enumeration Date | 2018-07-20 |
| Last Update Date | 2024-08-07 |