| NPI | 1841435047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: OR MD161662) |
| Additional Taxonomies | 2085R0204X Radiology Vascular & Interventional Radiology (Licence: NH 15785) |
| Enumeration Date | 2008-12-03 |
| Last Update Date | 2023-01-31 |